SUMMARY OF CHAPTER XIII 



ON THE ALLEGED PRODUCTION OF BARLOW'S DISEASE AND RICKETS 

 BY THE USE OF HEATED MILK FOR INFANTS 



CASES of Barlow's disease have always attracted, and will probably 

 continue to attract, very considerable attention on the part of 

 the medical profession. The acute symptoms, followed by their 

 rapid subsidence under adequate treatment, compel attention, 

 although the disease cannot be regarded as in any sense one of 

 common occurrence. 



It has been stated to be due to the use of heated milk, but the 

 degree of heat and the method of heating employed have not in 

 every case received that attention which they deserve, before the 

 statement was made. 



Most physicians appear now to have relinquished the general 

 idea that this disease is produced by the heating of milk, but it 

 cannot be said that an adequate explanation of its etiology has been 

 reached. 



The details of cases given in discussions upon Barlow's disease 

 which took place in Berlin in 1903, and in America in 1898 and in 

 1914, seem to show that there may be a close connection between 

 the two-fold heating of milk and the production of Barlow's disease. 

 It is not, however, clear whether such a connection may not be 

 closely related to the length of time the milk has been kept. 

 One of the great dangers of heated milk on a commercial scale, 

 is the tendency for such milk to be kept longer than would have 

 been the case had the milk not been heated. A false sense of 

 security appears to be engendered by the heating of milk, which 

 induces both the salesman and the consumer to delay unduly the 

 consumption of the milk. 



A large number of the cases of scurvy have been shown to be 

 associated with the use of proprietary foods of different types, 

 and occur mainly among the children of the well-to-do. Breast- 

 fed babies are not exempt from this disease. It would seem that 

 a monotonous dietary may produce the disease, as also one which 

 is remote in quality from the child's normal food. 



The increasing attention which is now bestowed upon infant 



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