68 GASEOUS METABOLISM OF INFANTS. 



led us to install in the ward a crib so adjusted as to give kymographic 

 records of the degree of activity or quiet, like those obtained with the 

 respiration chamber. 1 The infant selected for observation was placed 

 in this crib for 24 or 48 hours and a graphic record of his muscular 

 activity secured for the whole period. In one instance an infant who 

 was said to be the " quietest baby in the ward, hardly moving all day," 

 gave a surprising record in that it showed that she actually moved a 

 great deal and that there were only a few hours out of the whole 24-hour 

 day in which she was truly quiet. 



HOSPITAL RECORDS. 



The routine histories, records of the physical examinations, notes 

 regarding the urine, stools, blood, and temperature, the pulse and respi- 

 ration charts, and detailed records of the food were kept for all of the 

 infants. The Wassermann reaction and the von Pirquet skin tests were 

 also made in many of the cases noted in the statistics. It does not 

 seem desirable to publish the complete hospital record of each infant 

 that came under observation, as such an amount of detail would make 

 it impossible to find the essential points without too much labor. This 

 is particularly true because most of the evidence is negative as to 

 whether or not an infant is normal. One complete record of a typical 

 case will therefore be given and only such information recorded for the 

 other cases as has a bearing on the metabolism or is pathological in 

 character. 



TYPICAL RECORD. 



Subject, F. B. Male; date of admission to hospital, April 22, 1913; age, 5? 

 months. 



Preliminary diagnosis. Feeding. 



Family history. Father and one other child living and well. Mother lame 

 from an old infantile paralysis. She was operated on in the Massachusetts 

 General Hospital a year ago for "intestinal obstruction" which came on when 

 she was 2 months pregnant. 



Past history. Full term, instrumental delivery. Birth-weight, 4.54 kg. 

 Breast-fed, 6 days, then mother had blood poisoning and infant was weaned. 



Present illness. From the age of 10 days until admission to the hospital, 

 has had recurring boils on different parts of the body. Was fed for two months 

 on modified milk and lactose and after that a proprietary food was substituted 

 for lactose because he was not doing well. Is now getting 2.7 per cent of fat, 8 

 per cent of sugar (extra sugar in the proprietary food), 2.1 per cent of protein, 

 6 feedings of 5 ounces. Takes bottle well, does not vomit Is very constipated 

 in spite of magnesia and orange juice. 



Physical examination. Fairly developed, poorly nourished. Bright and 

 intelligent. Strong cry. Almost no subcutaneous fat. Muscles small but 

 firm. Holds head up and sits up without support. Skin of trunk shows 

 scars of old furuncles and on scalp are two which have almost healed. There 

 is a fine papular eruption on back of neck and between shoulders. Head well 

 shaped. Anterior fontanelle depressed and measures 2X2 cm. in diameter. 



l For description see p. 59. 



