78 GASEOUS METABOLISM OF INFANTS. 



digestion quickly became normal when she was given milk properly modified, 

 with a fuel value of about 140 calories per kilogram of body-weight. 



Subject, L. 0. Male; born September 5, 1912; birth-weight, 3.75 kilograms. 



This infant had always been fed with the bottle on mixtures of various 

 proprietary foods, with little or no cow's milk. He lost weight on this diet 

 and had never regained his birth-weight. When he entered the hospital at the 

 age of 4^ months (January 29, 1913), the physical examination showed that he 

 was a small, rather emaciated infant with a pinched face and practically no 

 subcutaneous fat. The musculature was slightly flabby and he was unable 

 to hold up his head. The cry was fairly strong and he seemed bright. The 

 physical examination was otherwise normal. His weight on entering the hos- 

 pital was 2.93 kilograms and it continued about the same until approximately 

 February 15, when he began to gain slowly. On March 10 he weighed 3.32 

 kilograms. After that date his temperature was elevated and it was dis- 

 covered on March 14 that he had measles. During the period when his meta- 

 bolism was being determined, his temperature in the wards varied between 

 36.1° C. (97° F.) and 36.7° C. (98° F.), being subnormal in the morning and 

 usually reaching 36.7° C. (98° F.) in the afternoon. On March 12, the tem- 

 perature became elevated with the prodromal symptoms of measles. 



He was a very much under-weight and under-nourished infant, with an 

 indigestion which was presumably due in the first place to too much sugar in 

 the diet and secondly to too much fat. There was no difficulty in digesting 

 protein in relatively large amounts. His diet during his stay in the hospital 

 was cow's milk modified to suit his digestion, and on this he gained slowly and 

 consistently in weight until he had measles. The stools were at first loose, 

 watery, and acid, but after the food was regulated they became firm, solid, 

 and alkaline. He weighed less than his birth-weight when he should have 

 weighed almost double his birth-weight; taking into account the subnormal 

 temperature, general appearance, and history, he might be considered a case 

 of infantile atrophy. 



Subject, J. P. Male; born prematurely at 7 months April 11, 1913; birth- 

 weight, 2.05 kilograms. 

 He was never breast-fed, but was given condensed milk, or modified milk 

 with a proprietary food; he had never thrived on this diet. He entered the Float- 

 ing Hospital August 14, 1913; his physical examination was negative at this time, 

 except for emaciation. He gained in weight up to 4 kilograms, but then had 

 indigestion, and was given a formula containing malt soup, which resulted in 

 a gain in weight up to 4.54 kilograms. On September 12, 1913, he entered 

 the Massachusetts General Hospital and was found on physical examination 

 to be moderately emaciated, with an indigestion due to too large a proportion 

 of fat in the diet. He was put on a diet of modified milk, regulated to his 

 digestion, and on September 28 began to gain rapidly. On October 25, he 

 weighed 5 kilograms and on November 8, 5.5 kilograms. He was happy and 

 smiling, well covered with fat, and his physical examination was normal. He 

 was, however, approximately 2 kilograms under weight, as the average weight 

 for his age (7 months) is 7.7 kilograms. Since he weighed 1.35 kg. less than 

 the average at birth, he would have weighed 6.4 kg. if he had gained nor- 

 mally. On this basis, he weighed 0.9 kg. less than he should have weighed. 



Subject, W. P. Male; born August 23, 1912; birth-weight, 2.73 kilograms. 

 His history previous to his coming to the hospital was unimportant, save 

 that his food contained practically no fat, he was very constipated, and not 

 gaining in weight. On January 24, 1913 (age, 5 months), he entered the 

 hospital ward to have his metabolism determined. At that time he was an 



