82 GASEOUS METABOLISM OF INFANTS. 



pital he received both breast milk and modified milk. His digestion and 

 temperature were normal. He weighed about 2 kilograms more than the 

 average infant of the same age (5| months), his weight remaining stationary 

 at 9.28 kilograms while he was in the hospital. 



Subject, J. V. Female; born prematurely at 8 months on October 10, 1912, of 

 a syphilitic mother; birth-weight, 1.45 kilograms. 



She lost weight until at the end of the first week she weighed only 1.30 

 kilograms. For the first 4 weeks she was fed on human milk; she was then 

 discharged from the Boston Lying-in Hospital to the Massachusetts General 

 Hospital, which she entered on December 13, 1912. At this time she was a 

 moderately nourished, poorly developed infant, about 45 cm. long. She cried 

 lustily and took her food with a Breck feeder without help. A diagnosis of 

 congenital syphilis was made by the skin department of the hospital before 

 she entered the Children's Ward. From December 25 onward, she was given 

 inunctions of mercury, one-half strength, until her discharge from the hospital. 



On December 15, two days after her entrance, the temperature became 

 elevated and remained so until the 20th, when it was found that she had an 

 acute otitis media. After paracentesis, the temperature dropped to normal 

 and remained there for several weeks. On March 11, the temperature again 

 became elevated and 2 days later it was found that the infant had measles. 

 The temperature remained elevated 7 days. She was allowed out of quaran- 

 tine on March 27. On March 31 she again had acute otitis media, which was 

 relieved by paracentesis. The ears continued to discharge until April 10; 

 two days later paracentesis was once more necessary and there were symptoms 

 of adenoid obstruction. On April 17, the adenoids were removed under ether, 

 thus relieving the obstruction. After this the infant ate, acted, and looked 

 better. On April 20 it was noted that there was marked craniotabes, a 

 moderate rosary, a liver which could be felt 4 cm. below the edge of the ribs, 

 and a spleen 3 cm. below the ribs. The ears stopped discharging shortly after 

 the adenoids were removed and the general condition was much improved. 

 On May 12, the record was made that she "laughed out loud." 



She was fed on increasing strengths of modified milk. Her digestion was 

 weak during most of her stay in the hospital. The weights recorded were 

 as follows: October 10, 1912 (birth-weight), 1.45 kilograms; December 14, 

 1.84 kilograms; January 1, 1913, 1.84 kilograms; January 15, 1.92 kilograms; 

 February 1, 2.05 kilograms; February 15, 2.22 kilograms; March 1, 2.50 kilo- 

 grams; March 15, 2.70 kilograms; April 1, 3.10 kilograms; April 15, 3.00 

 kilograms, this being double her birth-weight; May 1, 3.10 kilograms; May 

 12, 3.33 kilograms. Although she doubled her birth-weight at 6 months, she 

 weighed less than half the average weight of infants of the same age. 



Subject, P. W. Male; born September 8, 1912; birth-weight unknown. 



His family and past history were unimportant. He entered the surgical 

 department of the hospital on March 26, 1913, because of acute retention of 

 urine due to a horse hair tied tightly around the base of the penis. This was 

 quickly relieved by removing the cause. His physical examination was normal. 

 He was a healthy, well-developed infant, who acted normal in every way. 

 During his stay the infant was given modified milk and digested it well. His 

 food contained only about 85 calories per kilogram of body-weight, his weight 

 remaining stationary at 7.10 kilograms. Since his birth-weight is unknown, 

 it is impossible to calculate what his weight should have been for his age on 

 that basis, but this weight is approximately the same as the average for his 

 age. His temperature was normal and he could be considered a normal 

 infant of average development. 



