262 MEDICAL SECTION 



caloric need for weight and age of the normal healthy 

 infant, and knowing (as we have found to be the case 

 that the average thin, ill-nourished, ailing baby o 

 our institution fails to gain regularly and satisfactorily 

 in weight until he is taking from 30 to 40 per cent, 

 in excess of this, we can convey to our nurses without 

 difficulty what we want them to do. Take the case 

 of such a baby, aged 2 months, who has weighed 

 7^- Ib. at birth, and who weighs when brought 

 in, say 8 Ib. The average need of a small but 

 healthy, well-nourished baby at 2 months, weighing 

 8 Ib., would, of course, be about 8 x 50 = 400 calories, 

 or, roughly speaking, the equivalent of a pint of 

 human milk, or standard humanized milk. Without 

 entering into any calculation himself, the doctor might 

 say to the nurse : " Start the baby with one part of 

 humanized milk to two parts of 2\ per cent, sugar of 

 milk solution (or two parts of water, or of 5 per cent, 

 white of egg water, or of barley water, or what not). 

 At first let the daily caloric allowance be less than 

 a half of the baby's theoretical requirement, and if 

 all goes well work up gradually to the full caloric 

 allowance, in a week or ten days, by using a smaller 

 and smaller proportion of the diluent. Having arrived 

 at full strength, try to cautiously advance the caloric 

 to one and a third of the theoretical during the follow- 

 ing week or ten days." Complex as this may seem, 

 the average professional nurse, duly trained, can work 

 the whole thing out in ten minutes on simple lines 

 which we have devised thus proving herself, as 

 Florence Nightingale so aptly said the properly 

 trained and educated nurse should be, a help and 

 not a hindrance to the doctors. Indeed, in New 

 Zealand, while the position we took up in this con- 

 nection was questioned at first by many of the doctors, 

 I am glad to say that now they come forward to tell 

 us what admirable work the Plunket nurses are 

 doing, how they can rely on them, the saving of 



