72 GASEOUS METABOLISM OF INFANTS. 



passed 4 to 6 stools a day. An analysis of his mother's milk showed that it 

 was very weak. He entered the hospital when 9 months old (November 3, 

 1913), with a severe secondary anaemia. His weight at that time was 5.70 

 kilograms. When the blood was examined, it was found that while the dif- 

 ferential count of the white cells was normal, there was but 35 per cent of 

 haemoglobin (Talquist), 18,000 white blood corpuscles, and 2,712,000 red cells. 

 The Wassermann reaction was negative. The physical examination showed 

 that the infant was well developed and fairly nourished. The skin and 

 mucous membrane were of a pale lemon color. The edge of the liver was felt 

 2 cm. below the edge of the ribs and the spleen was hard, extending down to 

 the crest of the ileum. There was but a small amount of subcutaneous fat. 

 The digestion was normal, but it was often necessary to feed him with a 

 stomach tube. When discharged from the hospital on December 27, 1913, he 

 weighed 5.60 kilograms. The case was diagnosed as splenic tumor with a 

 severe grade of secondary anaemia. His weight on entering the hospital was 

 2.8 kilograms less than the average for an infant of his age. 



Subject, J. B. Male; born October 19, 1912; birth-weight unknown. 



This infant entered the skin ward of the Massachusetts General Hospital 

 on February 21, 1913; his weight at that time was 3.06 kilograms. He was 

 described as a poorly developed and nourished infant with an eruption typical 

 of congenital syphilis. After inunctions of mercury were given him, the 

 external evidence of syphilis disappeared. The physical examination was 

 otherwise normal. During the 5 weeks this infant remained in the hospital 

 he gained very little until the week preceding his discharge, when he gained 

 approximately 0.5 kilogram, weighing when discharged 3.74 kilograms. His 

 case was diagnosed as one of hereditary syphilis. He was very much under- 

 weight, weighing about 3 kilograms less than the average weight for his age. 

 During the last week he was gaining weight and therefore may be considered 

 as in the convalescent stage of infantile atrophy with syphilis. 



Subject, L. B. Female; born at full term in September, 1912; birth-weight, 



3.86 kilograms. 



She was breast-fed for the first 2 months and subsequently fed on a mixture of 

 milk, a proprietary food, and water. Her digestion was poor and she lost a 

 little weight. She entered the hospital January 24, 1913, age 4 months, to have 

 her metabolism determined. At this time she was a small, thin, but healthy- 

 looking infant, with but little subcutaneous fat. She was not emaciated, 

 however, and appeared well. She held up her head, but could not sit up with- 

 out support. Her physical examination was normal. She was fed on modi- 

 fied milk in the usual proportions, her weight increasing from 3.89 kilograms to 

 4.07 kilograms, after which she ceased to gain. She was moderately under 

 weight, as the average weight for an infant of 4 months is 6.25 kilograms. If 

 she had grown in the usual way from birth, she would have weighed about 0.5 

 kilogram more than the average weight for an infant of this age. The hospital 

 diagnosis was " regulation of feeding." 



Subject, L. R. B. Female; born June 24, 1913; birth-weight, 4.08 kilograms. 



This infant had always been breast-fed and had gained in the usual manner. 

 She entered the hospital when 4 months old (October 31, 1913), to have her 

 metabolism determined, and for weaning, as the mother was obliged to work. 

 The physical examination showed that she was a well-developed, well-rounded 

 infant, with the normal musculature and subcutaneous fat. The organs were 

 all normal. On November 1 and November 3, modified milk was given her 



