248. Missouri Agricultural Report. 



milk is too high the first step is dilution — usually with water, and as 

 that makes the per centages of both the fat and sugar too low, these 

 were then increased by the addition of cream and sugar. 



This scheme had scarcely been fully adopted before it became evi- 

 dent that the per cent, of the the various food elements was not the 

 only point to be considered, but there were qualitative differences which 

 must be kept in mind. The question of the protein was the first 

 stressed. The table shows clearly that a much greater proportion of 

 the protein in human milk is in the form of albumen than in the cow's 

 milk. This, combined with the fact that many infants suffering from 

 troubles of indigestion passed huge masses or curds that might easily 

 be taken for casein curd were they untested, and even on chemical 

 analysis are difficult to distinguish from casein curds. This leads to 

 the further dilution of the milk and the addition of more cream; and 

 also the use of lime water and various cereal waters as diluents of the 

 milk instead of water, as by means of these it was possible to separate 

 the casein particles and a less dense curd would be formed. 



Chemical test eventually came to show that these so-called casein 

 curds were in the large part not casein but calcuim soaps. Casein 

 curds, it is true, do sometimes appear in the stools of infants but are 

 quite different in appearance from the more frequently appearing 

 masses of calcium soap. The surest test for the mother, if the curds 

 are at all soft and not tough, is to substitute a skim milk mixture for 

 the cream mixture she has been feeding, and if the curds disappear she 

 may be sure they were caused by the fat. She can then gradually in- 

 crease the fat until the curds reappear. She will be safe if she keeps 

 just below this limit. 



The casein and fat being in disrepute, it is natural that great de- 

 pendence should be put upon the sugar. This has tended to the use of 

 increased amounts of sugar and especially in those infants that were 

 suffering from any nutritional disturbances. 



The effect of too much sugar in the diet has been more difficult to 

 clear up because its results are not so easily demonstrated. If the cream 

 is undigested it appears as casein curds in the stools, if fat is causing 

 the trouble the large masses of calcium soap or smaller flecks of unsplit 

 fat are easily distinguished. But where must we look for the sugar? 

 Not in the stools, for the digestion of the sugars which appear in the 

 diet of an infant is comparatively a simple process and it is usually 

 absorbed almost completely, or else split by bacteria. .But what happens 

 after absorption? It was found by German investigators as early as 

 1907 that children ill with gastro-intestinal troubles were excreting 



