STATISTICS OF OBSERVATIONS. 77 



Subject, J. M. Male; born July 28, 1912; birth-weight not known. 



For the first two weeks after birth he was breast-fed; subsequently he was 

 given whole milk diluted with water, which seemed to agree with him. Then 

 he had diarrhea and was fed condensed milk. When 5 months old he was 

 brought to the Out-Patient Department of the Massachusetts General Hospital, 

 as he was constipated and not gaining. His weight on January 9 was 5.20 

 kilograms, or 1.60 kilograms below the average weight for this age (5 months). 

 He was given milk suitably modified and gained weight slowly, his stools show- 

 ing good digestion. About this time he had several colds. On March 6 he 

 developed an acute otitis media which necessitated opening both ear drums; 

 the discharge from the ears persisted up to the date of his entrance to the 

 hospital ward on March 27, 1913 (at the age of 8 months). At this time he 

 was found to be fairly well-developed and nourished, with a moderate amount 

 of subcutaneous fat. The head was somewhat square and there was a slight 

 rosary. There was a purulent discharge from both ears. All the peripheral 

 glands, including the epitrochleas, were easily palpable, being the size of small 

 shot. The physical examination was otherwise normal. Although the dis- 

 charge from the ears continued, the ear infection caused no elevation of tem- 

 perature after April 1 and no other symptoms. He was given milk modified 

 to suit his digestion, with a fuel value of about 140 calories per kilogram of 

 body-weight. His digestion was normal. At the time he entered the hospital, 

 his weight was 5.50 kilograms; when he was discharged it was 5.63 kilograms, 

 these weights being about 2. 5 kilograms below the average for his age (8 months). 



Subject, M. M. Female; born January 21, 1913; birth-weight, 3.18 kilograms. 

 She was fed on modified milk and did well until several days before coming 

 to the hospital, when she began to vomit after feeding and to have diarrhea. 

 Her mother gave her one-half ounce of castor oil and changed her diet to barley 

 water. The infant entered the hospital on May 28, 1913. The physical 

 examination showed her to be well-developed, strong, and bright, with a good 

 amount of subcutaneous fat. The skin was a little loose, indicating a recent 

 loss of flesh, but otherwise the examination was normal. The temperature, 

 which was elevated on the day of admission* soon dropped to normal. She 

 was given weak mixtures of modified milk which contained about half as much 

 food as she required to gain weight. Her weight remained stationary at 5.35 

 kilograms. This was about 1.15 kilograms lighter than the average weight 

 for an infant of her age (4§ months) and about 1 kilogram lighter than she 

 would have been had she developed consistently from birth. The diagnosis 

 was acute gastro-intestinal indigestion. 



Subject, E. N. Female; born November 17, 1912; birth-weight not known. 

 Previous to coming to the hospital she had been fed on various pro- 

 prietary foods, separately or in combination. She cried considerably and was 

 hungry. She did not vomit and her stools were soft, green, and foul. When she 

 entered the hospital on May 19, 1913, she was found to be a well-developed 

 and fairly well-nourished infant, with a strong cry. The subcutaneous fat 

 was in small amounts; the skin was lax and the muscles flabby, but the grasp 

 was strong and she was able to hold her head up. The rest of the physical 

 examination was normal. She cried very little while in the hospital, but 

 "ate, laughed, and slept." Her weight on entering was 5.40 kilograms and 

 on her discharge on June 2, 1913, it was 5.26 kilograms. She was 2 kilograms 

 below the average weight for an infant of her age (6 months), but was other- 

 wise normal in all respects. Her case was considered to be one requiring a 

 regulation of feeding, her condition being due to improper feeding, with prob- 

 ably too much carbohydrate. No permanent injury had been done, as her 



