DR. FRITZ B. TALBOT'S PAPER 327 



Directory, the following tests and examinations are 

 made : a complete physical examination of the mother 

 and the baby, including the hair, mouth, throat, heart, 

 lungs, breasts, glands, skin and bones, to exclude 

 contagious diseases, tuberculosis and syphilis ; the 

 mother's blood is taken for a Wassermann reaction ; 

 and finally a smear is taken of any vaginal secretion 

 and examined for gonococci (it is probable that the 

 gonococcus complement-fixation test will eventually 

 be performed on all cases). If all these examinations 

 are satisfactory, the woman is admitted and is ready 

 for a position. During the three years that the 

 Directory has been running, it has passed one hundred 

 and forty-seven wet-nurses. Seven others were not 

 accepted, two because of tuberculosis, one gonorrhoea, 

 and four syphilis (one of these women had a perfectly 

 normal physical examination but was found to be 

 specific by the Wassermann test). Five other women 

 passed the physical examination but were unsuitable 

 for wet-nurses because of insufficient breast-milk. 

 The wet-nurses are only allowed to go to a household 

 in which the family practitioner guarantees that there 

 is no danger to the health of the wet-nurse or her 

 baby. 



Finances. Originally, a fee of ten dollars was 

 charged by the Directory for supplying wet-nurses ; 

 the income from this fee was used to pay the running- 

 expenses, the balance being raised by private subscrip- 

 tion. Although some people could not afford to pay 

 the full fee, many others were willing to pay more ; 

 consequently this year the fee was raised to twenty 

 dollars. It is estimated that this, with an additional 

 source of income in the sale of drawn breast-milk at 

 25 cents an ounce, will pay nearly all the expenses 

 and the Directory will soon become self-supporting. 

 During the past year about sixty quarts of drawn 

 breast-milk were sold to families in which a few- 

 ounces were needed to tide over a critical period. 



