OBSERVATIONS BY HASSELBALCH. 31 



Meinhard Pfaundler 1 has shown in an interesting paper that an 

 infant, and especially an infant weakened from some illness, is unable to 

 oxidize the fat and albumin in the nourishment as completely as the adult, 

 and he has shown by experiments that this is due to some extent 

 to the small oxidative power of the liver tissue. 



Carbohydrates receive a prominent place as that constituent in milk 

 which is most easily and most completely oxidized under all conditions, 

 and which is therefore an important element in the feeding of the 

 infant, whose fat and albumin digestion is supposedly overworked. 

 In such cases the mother's milk is not the ideal food, for its contents of 

 fat and albumin (which can not be digested and whose products of 

 decomposition may do harm in the intestine) are altogether too large 

 and cause the child in reality to starve. 



In reviewing the extensive amount of literature on artificial feeding 

 of atrophic infants, it is evident that the composition which has had 

 the best results, Keller's malt soup (a modified Liebig soup), points 

 towards feeding largety with easily digested carbohydrates (maltose). 

 With this kind of feeding the formerly atonic and poorty-nourished 

 infant thrives and the disease is, as a rule, cured at one stroke. If, 

 therefore, it is demonstrated that mother's milk is not the most favor- 

 able nourishment in all pathological cases, it is well, bearing the previ- 

 ous results in mind, not to take it for granted that mother's milk is 

 indicated in the case of the premature infant, but to consider whether 

 feeding with relatively large amounts of carbohydrates would not be 

 preferable. 



CONCLUSIONS. 



I. The well-nourished infant, born at full term, has a store of carbo- 

 hydrates (glycogen) in its organs, which is spent in the course 

 of a few hours. 



II. The metabolism of a poorly-nourished and premature infant 

 depends chiefly on the oxidation of carbohydrates during the 

 first hours of life. 



III. There is every reason to suppose that the metabolism of the 



normal, well-nourished human fetus consists of the oxidation 

 of carbohydrates. 



IV. When the infant is fed with mother's milk, the respiratory metab- 



olism shows a mixed quotient, which varies with the meals 

 in such a way as to indicate that milk sugar is the element 

 most quickly burned, that is, about 1| hours after the meal. 

 This fact is confirmed by experiments. 



V. The amount of the infant's metabolism is to a very large extent 

 dependent upon muscular contractions. At 32 C. and with 

 least possible work, the metabolism per kilogram is hardly 

 greater than that of the adult at absolute rest. 



VI. The relative ease with which carbohydrates are digested favors 

 their extensive use in cases where the ability to digest the 

 other constituents of human milk is decreased. 



1 Meiuhard Pfaundler, Jahrb. f. Kinderheilk., 1901,54, p. 247. See also here a large amount of 

 literature on the subject. 



