HENRY F. HELMHOLZ, M. D. 109 



removing the sugar from an incipient case, he could prevent 

 its development. In like manner, he discovered that the sugar 

 was responsible for those cases in which there was only increased 

 peristalsis, loss of weight and fever; and that its withdrawal 

 caused a prompt cure. 



Two of the symptoms in particular deserve mention because 

 of their intimate association with bacterial infection, namely, 

 fever and polymorpho-nuclear leucocytosis. It has been defi- 

 nitely proven by the experiments of Meyer, Schloss and others, 

 that salt solutions and sugar, when given per os to dyspeptic 

 children can produce fever of 102 F. 104 F., and polymorpho- 

 nuclear leucocytosis as high as 30,000. We see thus that sugar 

 can produce symptoms that we have been accustomed to associate 

 only with bacterial infections. 



Lactosuria is another symptom to which I wish to call atten- 

 tion more in detail, because of its early appearance (it may be 

 the first symptom of an impending intoxication) and because 

 of its relation to the understanding of the condition as one of 

 disturbed metabolism. The normal infant can handle from 2 

 to 3 grams of lactose per kilo of body weight. If more than 

 3 grams per kilo are given,, the child will excrete lactose in the 

 urine. In intoxications the tolerance for lactos'e is greatly 

 reduced; even when as small an amount as 5 c. c. of mother's 

 milk is given at a time, the urine may show a decided reaction 

 for sugar. Figuring mother's milk at 7 per cent, sugar, would 

 make the tolerance less than 1/80 to 1/100 that of a normal 

 child. This is explained by the assumption that the intestinal 

 lining has been so changed that the sugar, instead of being split 

 as normally is rapidly absorbed and excreted through the kid- 

 neys. The normal permeability of the intestinal mucosa has 

 been so changed that other toxic products might be absorbed. The 

 question as to whether the sugar thus overflowing into the circu- 

 lation acts toxically is still a mooted one. 



As a natural development of this study, came the therapeutic 

 food that has been brought forward during the last year by 

 Finkelstein and Meyer. The excellent results obtained with this 

 food prove, in a very definite and concise way, the importance 

 of the saying that the elements of the milk cannot be considered 

 separately, but must be considered as a whole. The fat, is con- 

 sidered by many the most dangerous element of the milk in the 

 etiology of acute gastro-intestinal disturbances. In former times 

 the casein has been accused of being the element of cow's milk 

 in which the dangers of artificial feeding centered. Here these 

 two constituents are given the infant in large amounts, but in a 

 mixture poor in sugar. In this form of albumin milk, they are 



