Advantages of the Natural Feeding of Infants.—The natural method of nourishment—that is to say, suckling at the maternal7 breast, is the only method of infant-feeding which properly complies with natural requirements. The adoption8 or non-adoption of this method is a matter of decisive influence upon the subsequent health of the child. The ideal is that the child should be suckled until it is nine months old. But, at least, we should insist upon the mother giving suck for the first weeks of the infant’s life, two months being regarded as an irreducible minimum. After two months, the dangers of artificial feeding are considerably9 less. Within certain limits, the longer infants are suckled, the lower are their disease-rate and death-rate, the greater is their power of resistance to disease, and the higher is their mental capacity. When we compare the results of natural feeding with those of artificial feeding of infants, we cannot fail to recognise that the former method gives children greater powers of resistance to and recovery from those diseases which are inseparable from the nutritive processes. Artificial feeding frequently leads to illness, life-long debility, premature10 death, &c. In children suckled by their own mothers, digestive disorders12 are usually trifling13; in children suckled by a wet-nurse, such disorders are more frequent and more obstinate14, but are seldom really dangerous; in artificially-fed infants, such disorders are extraordinarily15 common, their course is extremely serious, and a fatal issue is far from rare.
Statistical16 data prove beyond question that methods of feeding have a great influence upon infant mortality. The death-rate is higher in proportion to the degree to which the mode of nutrition diverges17 from the natural method of suckling by the child’s own mother; the death-rate is higher in children suckled by wet-nurses than in those suckled by their own mothers; it is much higher in children fed on cow’s milk[127] than in breast-fed children. Among 1000 children dying during the first year of life, medical returns show that 450 succumb18 to digestive disorders and marasmus. Many physicians go so far as to ascribe 70 per cent. to 80 per cent. of all infantile deaths to artificial feeding. A statistical error arises in this way, that children dying immediately after birth, before they could have been put to the breast at all, are apt to be included among the deaths due to artificial feeding, whereby, of course, the evil effects of this practice are overestimated20. Where artificial feeding is badly carried out, the infantile mortality is enormous. The children that escape death tend to become rachitic, an?mic, or weakly, and later in life readily succumb to tuberculosis21.
The enormous importance of natural feeding, and the extent of the difference between artificial and natural feeding, are manifested by the following examples: The statistics of child mortality invariably show that in those European countries in which most children are suckled by their mothers, child mortality is lowest. In Sweden and Norway, where even the wealthiest mothers suckle their own children, mortality during the first year of life hardly amounts to 10 per cent., whereas in other European countries the infantile death-rate is 12 per cent. to 15 per cent., or even more. It is erroneously believed that there is a law in Sweden making it obligatory22 upon mothers to suckle their children. No such law exists. During the siege of Paris, in the years 1870–71, the infant mortality in that city fell from 30 per cent. to 17 per cent. The reason for this fall was that the Parisian women were forced to suckle their own children, for, owing to the siege, cow’s milk was unattainable, and the usual supply of wet-nurses from the country was cut off.
Natural feeding is not only better than artificial, but also cheaper. Of course, in considering the question of the cost of artificial feeding, the method employed has to be taken into account. For example, artificially-fed infants are often given much more milk than they really need. But artificial feeding is artificial, and whereas instinct prescribes the methods of natural feeding, it gives no guidance in the matter of artificial feeding. The changes occurring in the female breast in consequence[128] of pregnancy23 and childbirth draw a woman’s attention to the fact that she has certain maternal duties to fulfil. The neglect of nature’s commands commonly entails24 disorders to health. It remains uncertain whether disease germs can be transmitted to the infant through its mother’s milk. It is still more questionable25 whether, in the act of suckling, vitally important maternal qualities can be transmitted from mother to child. There is some doubt whether the continuance of lactation is a fairly sure preventive of the occurrence of a fresh pregnancy. If this question can definitely be answered in the affirmative, there can be no doubt that for a mother to suckle her infant gives an increased chance of life not to that infant only, but to the other children in the family, because thereby26 these children are relieved of the dangers entailed27 by too large a family.
History of Artificial Feeding.—It is uncertain during what respective periods of human history the practice of rearing infants by means of wet-nurses, and the practice of rearing them by artificial feeding, first made their appearance. To-day, certainly, both these methods of rearing infants prevail very widely—far more widely than at any former time. No official statistics exist showing the proportion of all infants born alive that are suckled by the mother, suckled by wet-nurses, and artificially fed, respectively. According to some private investigators28, in large towns less than half of all infants are suckled by their own mothers, and in France the proportion of those which are otherwise nourished is said to range from 60 per cent. to 70 per cent. Certainly, the conditions with regard to this matter are worse in France than they are elsewhere.
Many physicians believe that the constitutional incapacity of women to suckle their children is increasing. They point out that an unused organ tends to atrophy29; and they consider, not merely that the incapacity to suckle is transmitted by inheritance, but that when so transmitted, the incapacity persists throughout all subsequent generations. But this view, whose soundness would deprive us of our most effective weapon in our campaign against excessive infant mortality, is erroneous. The recent investigations30 of various medical practitioners31 especially interested in the diseases of children[129] have shown that (even in districts in which for generations mothers have almost completely abandoned the practice of suckling their children), when properly advised, 90 per cent. of all women proved capable of suckling, if not for the full nine months, at any rate for a considerable period, before it was necessary to have recourse to cow’s milk. There are doubtless women who are really unable to suckle their children; and there are others who could do so, but in whom suckling is contra-indicated, either in their own interest or in that of the child. For example, a woman who is pregnant cannot give suck, for the human organism is not adapted to bear the common strain of pregnancy and of lactation. In the interest of the child that is being suckled, it is necessary that weaning should be effected directly a new pregnancy begins. Women suffering from chronic32 alcoholism and those addicted33 to morphine should not suckle their children, for the reason that a comparatively large quantity of the alcohol ingested, or of the morphine, as the case may be, is excreted in the milk. A child suffering from an infective disease, such as syphilis or tuberculosis, should be artificially fed, owing to the danger of infection.
Causes of the Failure to Suckle.—The reasons for a mother’s failure to suckle her infant may be classified under two main heads: she will not, or she cannot. Unwillingness34 plays a great part among the upper classes of society. Dread36 of inconvenience, laziness, fear of the loss of physical charms, social duties and pleasures to which such women devote a great deal of time, and which they are unwilling35 to renounce37—such are the considerations operative in these cases. Inability to suckle is a more frequent cause among women of the proletariat. In consequence of their poverty, such women are often forced to work away from home the whole day long. It is not yet definitely ascertained38 whether constitutional inability to suckle is commoner among proletarian women than among women of other classes. It is a greater evil for a proletarian mother to fail to suckle her infant than it is for a mother of the upper classes similarly to fail. The proletarian mother cannot afford to pay a wet-nurse, and the child must therefore be artificially fed. In this event, the[130] proletarian mother is likely to feed her child less well than an upper-class mother who also adopts artificial methods of feeding, for the former is too poor to obtain the best milk, and she lacks time to prepare the milk properly, and to give it to her child in suitably small quantities and at suitably short intervals39.
The idea that a smaller proportion of mothers of the poorer classes suckle their children than among the well-to-do is erroneous. But it is a fact that of those children who are not suckled by their own mothers, among the upper classes a much larger proportion are suckled by wet-nurses than among the lower classes; it is also the case that when children of the upper classes are not suckled by their own mothers, they commonly have wet-nurses in their own homes, and are not entrusted41 to the care of foster-parents; and finally, when we come to hand-fed children, among the upper classes a greater proportion of these are comparatively well fed than among the lower. A smaller percentage of illegitimate than of legitimate42 children are suckled by their own mothers; a larger percentage of the illegitimate than of the legitimate are artificially fed. The unmarried mother is in most cases poor, the birth of the child makes her poverty extreme, and by no means always does she receive a maintenance allowance from her child’s father. To be able to live, she must either act as wet-nurse to another woman’s child, or must go out to work.
Wet-Nurses.—Poverty not only makes it impossible for many women to suckle their own infants, but forces them to suckle the child of another. The great majority of wet-nurses are recruited from the ranks of the proletariat, and, indeed, for the most part, belong to the class of unmarried mothers. Married women are less inclined to sacrifice their own child for the good of the child of another woman. The readiness of many mothers to renounce the duty of suckling their children is perhaps referable to the fact that wet-nurses may be procured43 so easily and at such small cost. Thus poverty is also an indirect cause of the fact that many upper-class mothers fail to suckle their children. The children of wet-nurses are either fed artificially, or suckled by another[131] woman. The sad position of such children, and their enormous death-rate during the first years of life, are only too well known. When a woman takes employment as a wet-nurse, two children suffer—(a) the child she suckles, and (b) her own child, which would otherwise, in all probability, be suckled by its own mother. In favour of the traffic in wet-nurses, it is frequently maintained that the children of wet-nurses, owing to the good wages earned by their mothers, are well cared for, whereas otherwise they would be badly cared for. The sophistical character of this argument is sufficiently44 obvious.
If a child is not suckled by its own mother, it is either suckled by another woman, or else artificially fed; and the child may either remain in its maternal home, or it may be sent to be reared elsewhere. If the infant is sent elsewhere, either its relatives or some benevolent45 society may arrange for its care. Wet-nurses are thus resident or non-resident. In foundling hospitals, those wet-nurses who give suck to children in the institution are known as resident wet-nurses. From the standpoint of civil law, resident wet-nurses have entered into a contract of service with their employer, and the latter undertakes to provide in return for their services a stipulated46 remuneration. A non-resident wet-nurse, on the other hand, undertakes to provide in a certain manner for the infant boarded with her. It is obviously preferable that an individual child should be suckled by a resident wet-nurse, since in such conditions the wet-nurse can be supervised much more strictly47 than when she receives the infant in her own home. But in the case of children in a foundling hospital, it is preferable that they should be boarded out with non-resident wet-nurses, for in the present condition of medical science, the institutional care of infants is a very difficult matter to carry out with success.
But the choice of a wet-nurse involves other considerations in addition to those just stated. A woman can safely be employed in this capacity only if her own confinement48 has taken place some little time before. By suckling the child of another the wet-nurse deprives her own child of its natural nourishment. The wet-nurse may be suffering from some[132] infective disorder11, and may transmit this disorder to her nursling. Conversely, the nursling may be suffering from congenital syphilis, or from tuberculosis, and may infect the nurse. It is very difficult in infants-in-arms to recognise syphilis with certainty. For these reasons it is only to healthy wet-nurses, for whose own children a proper provision can be made (for instance, when the wet-nurse’s child has already been suckled for six months, or when it has died), that the local authorities give permission to suckle the child of a stranger. This applies both to resident and to non-resident nurses. In the case of the latter, in view of the fact already mentioned, that they cannot be properly supervised by the child’s relatives, supervision49 by the local authority is indispensable. There are no physiological50 difficulties in the way of suckling two infants, either simultaneously51 or successively. The latter procedure is, however, to be preferred. In all civilised countries baby-farming has been subjected to legal regulations. Although these regulations vary greatly in different countries, they relate not only to infants, but also to older children. The age at which supervision of such children ceases is a very variable one. As an example may be mentioned the French law of the year 1874. This law deals with children boarded out by foundling hospitals, but only to those under two years of age received for a money payment. It is becoming obvious to-day to most persons that children boarded out by their relatives require official supervision, even if the children are received gratuitously52.
Cow’s Milk.—Pure cow’s milk is the best substitute for the maternal milk. Where milk is to be used for infant-feeding, it should be drawn53 in a properly-kept cowshed, it should be cooled, placed for delivery in vessels54 of a suitable size for an individual infant’s meal, diluted55 or otherwise prepared as demanded by the age and special necessities of the case, and used as soon as possible. To-day the price of cow’s milk suitable for infant-feeding is so high that the lower classes find it almost impossible to obtain it. It is a matter of very great importance that good milk should be rendered available for the lower classes at a low price. Recently much attention has been paid to the improvement of the technique of milking,[133] of the transport of milk, and of the care of milk when delivered. The local authorities supervise the production and transport of milk as a part of their public-health administration. Improvements in cattle-breeding, a thorough organisation56 of the cowsheds and dairies and of the methods of milking, and an organisation of the entire dairy business have effected much improvement. Both private associations and the local authorities begin to lay stress on the supply of milk for infants, especially in towns, in which the provision of good milk is even more important than it is in country districts. We must leave the question open whether infants can be infected by the milk of cows suffering from Perlsucht or bovine57 tuberculosis; it certainly cannot be a matter of indifference58 whether the milk contains tubercle bacilli. At the present time, unfortunately, in the anything but hygienic dairies of our country districts, many of the cows are suffering from Perlsucht.
In many countries, especially France, Germany, and England, Infant’s Milk Depots59 (Gouttes de Lait) have been founded, at which the poor can obtain infant’s milk gratuitously or very cheaply. The deficit61 is made up by individual contributions, by public grants-in-aid, or by the profit on milk sold to the well-to-do. Of late years a few English municipalities have begun to administer such Infant’s Milk Depots themselves. Such Infant’s Milk Depots appear to do more harm than good. By providing milk gratuitously or very cheaply they give a premium62 to those mothers who feed their children artificially, and this leads many who would otherwise suckle their children to bring them up by hand. Vainly in France are prizes offered to mothers, and especially to unmarried mothers, to induce them to suckle their own children, when simultaneously institutions are founded to reward mothers who bring up their children by hand. Infant’s Milk Depots must be under continuous medical supervision, such supervision to include the mothers and children attending the depot60, since in default of this there is no guarantee that the mothers would use the milk properly in the nourishment of their infants. Of late it has been found necessary, especially in France, to associate with the administration of the Infant’s[134] Milk Depots the continuous medical supervision of the infants, medical advice to the mothers, control of the use of the milk, and advice to the mothers to suckle their own children. The French Infant’s Milk Depots are now associated with the giving of advice to mothers (consultation de nourrissons), so that the mothers can be properly instructed regarding all matters bearing on infant-feeding. Several times a week mothers’ classes are held, at which all possible stress is laid on the need for women to suckle their own children, this theoretical advice being re-enforced by the giving of prizes. If natural feeding is rejected or is impossible, advice is given as to suitable artificial feeding. Domiciliary visits are made to see that this advice is properly followed. Thus the Infant’s Milk Depots tend more and more to develop into centres for the general care of infancy; their original aim will pass more and more into the background as advice to mothers becomes associated with children’s clinics (such as we find already in many university towns), or with hospitals for infants, schools for midwives, and lying-in hospitals. Such a development may be expected in the near future.
Infant’s Milk Depots, advice to mothers, and all the institutions and measures forming part of the campaign to lower infant mortality, must invariably have the general aim of promoting the public welfare, and must never assume the form of Poor-Relief, otherwise many who need their services will fail to avail themselves of these, for, as is well known, a great many people are frightened away from any institution connected with the system of Poor-Relief. It is sufficiently proved that those Infant’s Milk Depots in which the milk is given in accordance with individual medical prescriptions63, which are subjected to medical supervision, which are associated with the giving of advice to mothers, which give milk free or at a low price only to those whose infants are kept under regular observation, promote breast-feeding by the mothers, and effect a notable diminution64 in infant mortality.
Other Methods of Artificial Feeding.—Nothing more need be said here of the other methods of artificial feeding—that is, of those in which no cow’s milk is used—beyond this, that they are in opposition65 to the essential principles of hygiene66,[135] and that they are of less than no value. Everyone who has the interest of society at heart should do all in his power to secure the complete discontinuance of such methods.
Institutional Care of Infants.—The institutional care of infants, if it is to be carried out in accordance with hygienic principles, is too costly67. Hence it is applicable only in the case of weakly and sickly infants, and is out of the question for the permanent care of healthy infants. With regard to the institutional care of healthy infants, it is asserted that, even in the most modern and best-managed foundling hospitals and hospitals for infants, epidemic68 diseases—such as pneumonia69, contagious70 ophthalmia, and intestinal71 catarrh—inevitably appear, and in such circumstances are extremely difficult to treat with success. It is, however, necessary to consider the following facts. Unquestionably, the institutional care of infants was formerly72 far from satisfactory. Certain diseases, the seeds of which have been sown in the institution, only develop in full severity after the child has been boarded out. This depends upon: (a) the primary lack of resisting power of the infants, which is the disastrous73 sequel of the unfavourable conditions of life to which they were exposed before entering the institution; (b) the lack of proper individualisation (for example, the continuous lying in bed, bad air, lack of sufficient cleanliness)—the so-called “hospitalism” or “hospital-marasmus” is referable to these influences; (c) a failure to meet the demands of hospital hygiene, so that the origination and the development of the infectious diseases are facilitated; (d) artificial feeding, by which the working of these evil influences is powerfully reinforced. But all these errors are avoidable. Nothing more is requisite74 for their avoidance than strict observance of the rules of modern hospital hygiene, with individualisation in all departments, and especially in the matter of diet, which should whenever possible be carried out through the instrumentality of wet-nurses. Since wet-nurses of the best quality are difficult to obtain in sufficient numbers, it is best that the hospital for infants should be associated with a lying-in hospital.
The Crèche.—In the families of the poor, the elder children have in most cases to work for their living, so that[136] even these are not continuously available for the care of the younger children. This applies especially to those families whose members work away from home, and in places to which the younger children cannot be taken. When a peasant with his wife and his elder children works in the fields, it is possible to take even quite little children to the place of work and to keep an eye on them there; but when a workman with his wife and his elder children works in a shop, a factory, or a workshop, to take the younger children there is impossible. But young children must on no account be left without supervision, for this exposes them to all kinds of dangers—to burns and scalds, falling out of window, &c. Moreover, an infant-in-arms cannot be entrusted to the care of the older children, if only for the reason that this is injurious to the latter alike in body and in mind. They have, for example, to drag the baby about with them wherever they go, are kept away from school, &c. To board out an infant is, in the first place, costly, and, in the second place, separates the infant completely from its parents. In many cases it is only by the fact that she keeps her child with her, and becomes attached to it, that an unmarried mother is restrained from adopting an immoral75 life. Thus there is need of a place to which the children may be sent, either permanently76 or only during the hours in which the family are at work. Institutions for this purpose actually came into existence only as a sequel of the development of the factory system. They are known as crèches, and provide for the care, not of infants merely, but of children up to the age of three. The need for and value of such institutions is obvious. It is a real service to parents of the poorer classes, if not far from their dwelling77 or from their place of work there exists an institution at which, either gratuitously or for a nominal78 payment, their little children can be properly cared for. Early in the day the mother takes her infant to the crèche, during the midday pause goes there if necessary to suckle the child, and fetches it home in the evening.
Illegitimate children are in many places refused admission to the crèches. This refusal merits our strongest disapproval79. The reasons alleged80 for this course are of two[137] different kinds. First, we are told that we must not encourage girls to be immoral; secondly81, it is said that married mothers will hesitate to entrust40 their children to a crèche which also receives illegitimate children. The injustice82 of this practice is more and more generally understood, and the better course more commonly prevails. Of course, only such illegitimate children should be received at a crèche as are cared for by their own mothers during the hours of the day when they are not at the institution. Illegitimate children boarded out with foster-parents should not be admitted to a crèche, because foster-parents who send to a crèche the child entrusted to their care are not properly fulfilling the duty they have undertaken, and those who cannot look after the foster-child themselves should not receive one at all.
In most countries crèches are founded and maintained by private benevolence83, and are merely supervised by the State. Only in a few countries—Hungary, for instance—has the State imposed upon the local authorities the duty of founding and maintaining such institutions; and the central authority has itself founded and maintained such institutions, and in these the matrons of the Public Homes for Children (Kinderbewahranstalten) receive their training.
To-day various defects exist in these crèches. Not infrequently the attendants lack the necessary experience in the care of children, medical supervision is often inadequate84, the building is unsuitable, the infants are artificially fed, the crèche is often too far from factory, workshop, or home, so that artificial feeding or feeding by a wet-nurse is encouraged. Before long crèches will become national institutions. They will become more numerous; they will be used more readily; their faults will be corrected.
Particular mention must be made of factory crèches and family crèches. (a) Many factory owners construct crèches and feeding-rooms for the infants of women working in their factories, and arrange for such women to leave work at intervals to suckle their children. The employers do this, not so much from the goodness of their hearts, as with an eye to their own well-considered interest. The working time they[138] lose amounts to very little, and they hope that their benevolent actions will secure the goodwill85, and consequently the hearty86 co-operation, of their workpeople. (b) A recent development is the family crèche. Adequate maintenance and free house-room are guaranteed to a widow, in return for her undertaking87 to care during the day for a restricted number of infants (and in some cases, also, children of school age). Family crèches share to some extent the advantages of the family care of infants. Their great and obvious advantage lies in the fact that they facilitate decentralisation—that is, the crèche can be nearer to the homes of the infants’ parents. Their main defect lies in their failure, as a rule, to satisfy the demands of modern hygiene; a second disadvantage is that systematic88 occupation for the older children is usually difficult to arrange in the family crèche. For these reasons it is unlikely that they will ever become very general.
Proposed Reforms.—Proper training and discipline are requisite, not only for midwives, but also for medical practitioners. Proper training of mothers is also necessary. Most young mothers seek advice above all from midwives, and these latter often advise very badly. In the first place, there are many matters connected with the care of infancy about which midwives have no expert knowledge. Secondly, midwives often advise mothers not to suckle their children, but to bring them up by hand, because the case is sooner done with and the midwife has less to do when the mother does not suckle.
In many German towns, a number of the institutions for the care of infants, and also the offices for the registration89 of births, distribute printed instructions regarding the care of infants, with especial reference to the matter of infant-feeding. The principle of these attempts is sound, but unfortunately many such leaflets are rather long-winded, and consequently remain unread.
It has been suggested that every woman entering upon marriage should have to display a knowledge of the elements of the hygiene of infant life, and more especially of the principles of infant-feeding; or else that the duty should be imposed upon women of acquiring the requisite knowledge within six months after marriage—by attendance at one of[139] a number of schools to be founded with this end in view. The idea of this proposal is sound, but it is one which it is hardly possible to put into practice precisely90 in the form here stated.
Radical91 Solution of the Problem.—It is one of the most important aims of child-protection that during the first year of life the infant should be nourished at the maternal breast. Every possible effort must be made to secure that the infant should not be separated from its mother; and if separation from the mother is unavoidable, that the child should not be hand-fed, but suckled by a wet-nurse. Finally, when artificial feeding of the infant is inevitable92, it is the aim of child-protection to secure that the technique of this feeding should be the best possible.
Two of the institutions of modern civil law are of such a nature as to favour wet-nursing and hand-feeding, and to hinder the attainment93 of the primary aims of child-protection. The first of these is that, within limits, the parents are free to determine how their child shall be brought up; so that, for instance, the mother is free to entrust her child to a wet-nurse, or even to have it brought up by hand. Hence the reform of these matters must begin with legislation securing that the legal position of legitimate and of illegitimate children shall be identical; and, secondly, imposing94 it upon all mothers as a legal obligation to suckle their own children when they are physically95 competent to do so.
The last-named measure is by some considered too radical, on the ground that its enforcement would infringe96 the sacred principle of the freedom of contract, and would violate the sanctity of family life. But these are merely empty phrases; and such considerations cannot for a moment counterbalance the urgent need for the proper protection of infant life. Even to-day, it is an accepted legal principle that in the case of contracts involving the personal service of the contracting parties within the limits of family life, the contract cannot be fulfilled by proxy97. Thus, in the matter of the nourishment of an infant during the first months of life—that is to say, in respect of the performance of an act which is merely the continuation and the sequel of the physiological state brought into being by sexual intercourse[140] and by pregnancy, the demand that no substitution be allowed, that lactation by proxy be prohibited, is a logical application of existing and accepted legal principles. In the sphere of family life, the principle of the freedom of contract finds even to-day no more than a restricted application; and with the disappearance98 of the economic order based upon free competition, the principle of the freedom of contract is destined99 altogether to disappear. Beyond question, the suggested reform would involve a very serious limitation of personal liberty. But the limitation would be no greater than those that are imposed in most modern States by various ordinances100 affecting the right of the individual to the free disposal of his own body—for instance, compulsory101 military service, compulsory vaccination102, and compulsory removal to a hospital for infectious diseases. The proposed reform would knit closer the bonds between mother and child, and it would curtail103 the love of personal luxury and the pleasure-seeking of the women of the well-to-do classes. The legal measure here suggested was known to the old Prussian law, and to this law alone. It does not appear in any legal code of to-day. The two reasons that prevent its immediate19 adoption by any modern State are these: in the first place, it would affect the women of the upper classes much more than those of the lower, and would expose the former in especial to punishment; in the second place, a necessary corollary of any such law would be the provision for women of the lower classes of a suitable allowance for maintenance during the period of lactation.
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infancy
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| n.婴儿期；幼年期；初期 | |
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indirectly
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| adv.间接地，不直接了当地 | |
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redound
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| v.有助于；提；报应 | |
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remains
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| n.剩余物，残留物；遗体，遗迹 | |
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nourishment
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| n.食物，营养品；营养情况 | |
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dilution
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| n.稀释，淡化 | |
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maternal
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| adj.母亲的，母亲般的，母系的，母方的 | |
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adoption
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| n.采用，采纳，通过；收养 | |
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considerably
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| adv.极大地；相当大地；在很大程度上 | |
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premature
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| adj.比预期时间早的；不成熟的，仓促的 | |
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disorder
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| n.紊乱，混乱；骚动，骚乱；疾病，失调 | |
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disorders
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| n.混乱( disorder的名词复数 )；凌乱；骚乱；（身心、机能）失调 | |
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trifling
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| adj.微不足道的；没什么价值的 | |
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obstinate
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| adj.顽固的，倔强的，不易屈服的，较难治愈的 | |
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extraordinarily
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| adv.格外地；极端地 | |
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statistical
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| adj.统计的，统计学的 | |
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diverges
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| 分开( diverge的第三人称单数 )； 偏离； 分歧； 分道扬镳 | |
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succumb
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| v.屈服，屈从；死 | |
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immediate
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| adj.立即的；直接的，最接近的；紧靠的 | |
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overestimated
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| 对（数量）估计过高，对…作过高的评价( overestimate的过去式和过去分词 ) | |
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tuberculosis
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| n.结核病，肺结核 | |
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obligatory
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| adj.强制性的，义务的，必须的 | |
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pregnancy
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| n.怀孕，怀孕期 | |
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entails
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| 使…成为必要( entail的第三人称单数 )； 需要； 限定继承； 使必需 | |
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questionable
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| adj.可疑的，有问题的 | |
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thereby
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| adv.因此，从而 | |
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entailed
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| 使…成为必要( entail的过去式和过去分词 )； 需要； 限定继承； 使必需 | |
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investigators
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| n.调查者，审查者( investigator的名词复数 ) | |
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atrophy
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| n./v.萎缩，虚脱，衰退 | |
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investigations
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| （正式的）调查( investigation的名词复数 )； 侦查； 科学研究； 学术研究 | |
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practitioners
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| n.习艺者，实习者( practitioner的名词复数 )；从业者（尤指医师） | |
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chronic
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| adj.(疾病)长期未愈的，慢性的；极坏的 | |
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addicted
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| adj.沉溺于....的，对...上瘾的 | |
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unwillingness
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| n. 不愿意，不情愿 | |
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unwilling
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| adj.不情愿的 | |
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dread
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| vt.担忧，忧虑；惧怕，不敢；n.担忧，畏惧 | |
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renounce
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| v.放弃；拒绝承认，宣布与…断绝关系 | |
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ascertained
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| v.弄清，确定，查明( ascertain的过去式和过去分词 ) | |
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intervals
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| n.[军事]间隔( interval的名词复数 )；间隔时间；[数学]区间；（戏剧、电影或音乐会的）幕间休息 | |
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entrust
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| v.信赖，信托，交托 | |
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entrusted
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| v.委托，托付( entrust的过去式和过去分词 ) | |
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legitimate
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| adj.合法的，合理的，合乎逻辑的；v.使合法 | |
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procured
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| v.（努力）取得， （设法）获得( procure的过去式和过去分词 )；拉皮条 | |
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sufficiently
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| adv.足够地，充分地 | |
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benevolent
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| adj.仁慈的，乐善好施的 | |
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stipulated
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| vt.& vi.规定；约定adj.[法]合同规定的 | |
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strictly
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| adv.严厉地，严格地；严密地 | |
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confinement
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| n.幽禁，拘留，监禁；分娩；限制，局限 | |
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supervision
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| n.监督，管理 | |
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physiological
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| adj.生理学的，生理学上的 | |
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simultaneously
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| adv.同时发生地，同时进行地 | |
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gratuitously
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| 平白 | |
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drawn
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| v.拖，拉，拔出；adj.憔悴的，紧张的 | |
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vessels
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| n.血管( vessel的名词复数 )；船；容器；（具有特殊品质或接受特殊品质的）人 | |
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diluted
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| 无力的，冲淡的 | |
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organisation
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| n.组织，安排，团体，有机休 | |
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bovine
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| adj.牛的；n.牛 | |
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indifference
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| n.不感兴趣，不关心，冷淡，不在乎 | |
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depots
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| 仓库( depot的名词复数 )； 火车站； 车库； 军需库 | |
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depot
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| n.仓库，储藏处；公共汽车站；火车站 | |
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deficit
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| n.亏空，亏损；赤字，逆差 | |
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premium
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| n.加付款；赠品；adj.高级的；售价高的 | |
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prescriptions
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| 药( prescription的名词复数 )； 处方； 开处方； 计划 | |
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diminution
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| n.减少；变小 | |
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opposition
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| n.反对，敌对 | |
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hygiene
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| n.健康法，卫生学 （a.hygienic） | |
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costly
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| adj.昂贵的，价值高的，豪华的 | |
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epidemic
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| n.流行病；盛行；adj.流行性的，流传极广的 | |
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pneumonia
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| n.肺炎 | |
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contagious
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| adj.传染性的，有感染力的 | |
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intestinal
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| adj.肠的；肠壁；肠道细菌 | |
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formerly
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| adv.从前，以前 | |
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disastrous
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| adj.灾难性的，造成灾害的；极坏的，很糟的 | |
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requisite
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| adj.需要的，必不可少的；n.必需品 | |
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immoral
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| adj.不道德的，淫荡的，荒淫的，有伤风化的 | |
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permanently
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| adv.永恒地，永久地，固定不变地 | |
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dwelling
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| n.住宅，住所，寓所 | |
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nominal
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| adj.名义上的；(金额、租金)微不足道的 | |
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disapproval
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| n.反对，不赞成 | |
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alleged
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| a.被指控的，嫌疑的 | |
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81
secondly
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| adv.第二，其次 | |
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82
injustice
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| n.非正义，不公正，不公平，侵犯（别人的）权利 | |
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83
benevolence
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| n.慈悲，捐助 | |
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84
inadequate
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| adj.(for,to)不充足的，不适当的 | |
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85
goodwill
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| n.善意，亲善，信誉，声誉 | |
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hearty
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| adj.热情友好的；衷心的；尽情的，纵情的 | |
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undertaking
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| n.保证，许诺，事业 | |
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88
systematic
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| adj.有系统的，有计划的，有方法的 | |
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registration
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| n.登记，注册，挂号 | |
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precisely
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| adv.恰好，正好，精确地，细致地 | |
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radical
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| n.激进份子，原子团，根号；adj.根本的，激进的，彻底的 | |
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92
inevitable
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| adj.不可避免的，必然发生的 | |
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93
attainment
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| n.达到，到达；［常pl.］成就，造诣 | |
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imposing
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| adj.使人难忘的，壮丽的，堂皇的，雄伟的 | |
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physically
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| adj.物质上，体格上，身体上，按自然规律 | |
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96
infringe
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| v.违反，触犯，侵害 | |
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proxy
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| n.代理权，代表权；（对代理人的）委托书；代理人 | |
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disappearance
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| n.消失，消散，失踪 | |
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99
destined
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| adj.命中注定的；(for)以…为目的地的 | |
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ordinances
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| n.条例，法令( ordinance的名词复数 ) | |
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101
compulsory
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| n.强制的，必修的；规定的，义务的 | |
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102
vaccination
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| n.接种疫苗，种痘 | |
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103
curtail
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| vt.截短，缩短；削减 | |
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