80 GASEOUS METABOLISM OF INFANTS. 



mixture of cow's milk, relatively low in fat, which gave him about 120 calories 

 per kilogram of body-weight. During his stay in the ward his digestion was 

 apparently normal. His temperature was normal or subnormal. He was an 

 undersized infant, whose digestion had been upset by over-feeding with fat. 

 When he entered the hospital, his weight was 3.07 kilograms, which was less 

 than his birth-weight. If he had developed in the ordinary way, he would 

 have weighed about twice as much, the average weight for an infant of his 

 age being 6.25 kilograms. When discharged from the hospital, he weighed 

 3.19 kilograms. His case was considered to be one of infantile atrophy. 



Subject, A. S. Male; born at full term Dec. 26, 1912; birth-weight, 3.75 kg. 

 His history was unimportant, as he had always been breast-fed. When he 

 entered the hospital on March 26, 1913, he was well developed and well 

 nourished, with a normal amount of subcutaneous fat and firm muscles. He 

 appeared strong and bright and held his head up without support. The 

 physical examination was normal. During his stay in the hospital he was 

 fed both breast and modified milk; his digestion was normal. It was neces- 

 sary to puncture his ear drums on March 29 to relieve an acute otitis media, 

 after which the temperature, which had previously been moderately elevated, 

 dropped to normal. His weight remained stationary in the week he was under 

 observation. He was a normal breast-fed infant, weighing approximately 6 

 kg. or about 0.5 kg. above the average weight for his age (3 months). 



Subject, E. S. Female; born of healthy parents on October 13, 1912 (pre- 

 sumably premature at about 7 months); birth- weight, 1.93 kilograms. 

 She was breast-fed for 3 months but did not gain. She was then put on a 

 diet of malted milk and later on a proprietary food, both of these being mixed 

 with milk. While she did not vomit, she spit up her food occasionally, and had 

 two brown stools a day which irritated the buttocks. When she entered the 

 hospital on March 19, 1913, she had not gained weight recently. On physical 

 examination she was found to be a poorly developed, thin infant, with an 

 anxious expression. There was no subcutaneous fat, and the muscles were 

 flabby. She appeared quiet but bright, and had a strong cry. The skin 

 showed a dull redness, with macular papular eruption on the chin, joints, and 

 buttocks. The physical examination was otherwise normal. She was fed on 

 milk modified to her digestion, with a fuel value of about 140 calories per 

 kilogram of body- weight; while under observation, her digestion was good. 

 This infant was much under the average weight and also under the weight 

 which she would have been had she gained consistently. With a history of 

 prematurity and a birth-weight of 1.93 kilograms, it would be expected that 

 at the age of 5 months (her age while in the hospital) she would weigh approxi- 

 mately 5.35 kilograms, whereas her average weight for this time was about 3 

 kilograms. The average weight for an infant of 5 months is 6.82 kilograms. 

 She was, therefore, considerably under weight. Furthermore, the tempera- 

 ture during her entire stay was subnormal. She was accordingly considered 

 to be a case of infantile atrophy. 



Subject, E. H. S. Male; born at full term Aug. 28, 1913; birth-weight, 3.18 kg. 

 He had always been fed on modifications of cow's milk or on condensed 

 milk, but did not thrive on any of the diets used. He had had symptoms of 

 indigestion ever since birth and had lost weight, weighing when he entered 

 the hospital on October 27, 1913, at the age of 2 months, only 2.4 kilograms. 

 He was a poorly developed and nourished infant, with the expression of an 

 old man. The face wrinkled when he cried, and the skin hung in folds on 

 his arms and legs. The fontanelles and eyes were sunken; the skin was dry; 



