STUDIES ON MILK SUGAR 



By HENRY F. HEL.MHOLZ, M. D., Chicago 



For my topic this evening, I have chosen a subject that deals 

 with one of the causes of infant mortality, and in its recogni- 

 tion as such becomes at once a means of reducing the excessive 

 death rate from the acute gastro-intestinal diseases. My sub- 

 ject is "Milk Sugar." To many, no doubt, it may be a surprise 

 to hear milk sugar spoken of as an important factor in the etiology 

 of these acute disturbances, but I hope to show you, before I 

 have finished, that the recognition of the danger of sugar to the 

 infant organism is one of the greatest advances in the solution 

 of the artificial feeding problem and, as such, a very important 

 means of reducing the excessive infant mortality. 



To my mind, relatively too much emphasis has been laid on 

 the freshness and purity of the milk and not enough on the form 

 in which it is given to infants. The idea that the problem of 

 infant mortality could be solved by furnishing all infants with 

 milk of low bacterial content, has predominated here in America. 

 The danger from pure milk per se and from the sugar in 

 particular has received very little, if any, attention. Take, for 

 example, the four stock formulae put up by the Milk Commis- 

 sion of Chicago. What is the underlying idea upon which these 

 modifications are based? The indigestibility of the cow's casein 

 for which there is practically no scientific or clinical proof. 



It is time that we understood what the relation of each of the 

 different elements of the milk is to the acute gastro-intestinal 

 disturbances, how these different components interact and how 

 each one of them can only be considered in its relation to the 

 others. As an example, let me cite the danger of fat when 

 given with high percentages of sugar; its relative harmlessness 

 when given with low percentages. 



For many years, the bacteria held the center of the stage and 

 our efforts were all directed toward finding a serum or vaccine 

 with which to master this disease. There can be no doubt that 

 specific bacterial infections do play a role in a small percentage 

 of cases; but the fact is equally certain that the great bulk of 

 the cases which make up our mortality records are clue to im- 

 proper feeding especially in regard to the sugars. 



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