DR. FREDERICK LANGMEAD'S PAPER 337 



disadvantage. Render the curd soft and flocculent, and 

 the fatty pellets may disappear from the motions. 

 Milk in any form is unsuitable for the epidemic diar- 

 rhoea of the summer months. There are also a certain 

 few babies who may truly be said to be born to die ; 

 without presenting- any gross lesions, they resist all 

 methods of feeding and gradually sink from inanition. 

 These subjects of " abiotrophy " are often born at the 

 end of long families or when the mother is getting on 

 in years, and are not endowed with sufficient vital force 

 to live. Failures in feeding by this method, as by any 

 other, are sure to be met with, too, if organic disease, 

 such as congenital syphilis or stenosis of the pylorus, 

 is present. 



One of the disadvantages which are said to attend 

 undiluted citrated milk is that it engenders constipation. 

 I have not been able to convince myself that this is 

 the case, although it is true that the motions are more 

 bulky ; nearly all the babies whom I have watched who 

 have suffered from constipation were similarly affected 

 before the citrated milk was begun. Urticaria and 

 erythematous rashes have been produced when sodium 

 citrate has been given in excess, but never, in my 

 experience, in the proportion here recommended. A 

 rational objection to whole milk is that more protein 

 is given than is present in human milk, and, therefore, 

 more than the infant needs. One can only say that it 

 does no harm when the curd difficulty is overcome by 

 citration. The size of the motion indicates that some 

 of this is passed, but I have no data as to the ratio 

 between the amount of protein utilized and that ex- 

 creted, and how this compares with the same ratio 

 when diluted milk is given. 



RESULTS. 



The progress in weight and strength of the infants 

 fed by this method fully justifies the claims which have 

 been made for it. 1 have now watched some hundreds of 



