102 The Philippine Journal of Science 1920 
increasing during the subsequent year. These patients received 
the cheapest kind of milk, which naturally contained very little 
fat. His treatment consisted only in breast-feeding, cod liver 
oil, and local treatment of the eyes. For older children he 
prescribed milk mixtures in addition to the oil. He calls at- 
tention to the fact that the lesions of the eyes may often be 
masked by a conjunctivitis, and that it is very probable that 
many cases of blindness and leucoma in the adult had their 
origin in an overlooked xerosis during infancy. The whole 
trouble, according to this observer, can be readily overcome by 
simply changing the diet to breast-feeding, and giving cod liver 
oil, the latter with or without sweetened whole milk. 
Czerny and Keller, and recently Bloch, observed similar cases 
in children fed exclusively on carbohydrates. 
Morand believes that the cause of this trouble is not entirely 
due to fat deficiency, as claimed by Bloch. After examining 
the records of his service, he found that two hundred five 
infants with fat-dyspepsia had been kept on a fat-poor diet 
for over two months without developing symptoms that might 
indicate disturbances from fat deficiency. He attributes the 
cause of xerophthalmia not so much to fat deficiency as to the 
pasteurization of the milk used. He mentions five infants with 
fat dyspepsia, complicated with pyuria, otitis, and pyodermitis, 
that were kept on a fat-poor diet, and that developed xerosis 
of the conjunctiva and showed no sign of growth. Up to a 
few months previous to illness these children were receiving 
raw milk; but, owing to a change in the management of the 
dairy, they had to be fed with pasteurized milk, which is in 
reality a denatured food and deficient in vitamines. 
In order to show that pasteurization of the milk was the real 
cause of these disturbances, Morand continued to give these 
children the same nourishment, plus 10 mils of fresh milk be- 
fore each feeding. This small quantity of fresh milk caused 
rapid disappearance of the xerosis. He believes that the suc- 
cess obtained was due to the vitamines and not to the small 
amount of fats contained in the 10 mils of fresh milk. 
Ronne, an ophthalmologist, has also observed cases of xeroph- 
thalmia in children fed on casein and little carbohydrates. 
According to him the serious symptoms as well as the xeroph- 
thalmia come on suddenly, a fact which in his opinion suggests 
that the lack of vitamines is the real cause of the disturbances, 
for excessive carbohydrate diet could hardly produce such a 
sudden and stormy onset of the disease. He further affirms 
