ALLEGED PRODUCTION OF BARLOW'S DISEASE 217 



feeding shows that it is impossible to lay down hard and fast rules 

 for the feeding of infants, although there can be little doubt that the 

 most suitable food for infants is the natural food, that is, the milk 

 of its mother. 



There is no evidence to show that the use of heated milk is 

 productive of rickets in young children. 



CHAPTER XIII 



ON THE ALLEGED PRODUCTION OF BARLOW'S DISEASE AND RICKETS 

 BY THE USE OF HEATED MILK FOR INFANTS 



THE literature upon the subject of Barlow's disease, its etiology, 

 course, and treatment, is too great for any attempt to be made to 

 consider it completely. It is merely proposed to give the more 

 important papers and the discussions dealing with a large number of 

 cases of this disease, which have been analysed by different authors. 



The first cases in the literature were published by Cheadle in 

 1878, but the cases quoted in the years following Cheadle's com- 

 munication do not appear to have been very numerous. 



In 1898 a full discussion on infantile scurvy took place in 

 Boston, Mass., by the American Pediatric Society. This society 

 sent out circular letters to numerous physicians, requesting them 

 to fill in the details asked for on the papers sent. The papers 

 contained questions on a comprehensive scale, dealing with the 

 number of cases seen, the food which had been given prior to 

 the onset of the disease, the treatment prescribed, and the results 

 obtained. Records of 379 cases of the disease were thus obtained 

 by the Pediatric Society. A committee was appointed to analyse 

 the records, which consisted of Drs. Griffiths, Jennings, and Morse, 

 and the results obtained were considered at a meeting of the Medical 

 and Chirurgical Society. A few of the details thus collected may 

 be given here. 



The age at which the disease occurred was found to vary from 

 three weeks to nine years, but the great majority of the cases 

 occurred between the ages of seven and thirteen or fourteen months. 

 The social circumstances of the children attacked were tor the 

 most part good. Eighty-three per cent, of the cases occurred in 

 the private practice of the physicians supplying the information, and 

 only 17 per cent, in their hospital practice. Out of the 379 cases, 

 the information given showed that in 303 cases the circumstances 

 were ' good/ a nd in only 40 cases were they described as ' bad.' The 

 diet before the onset of the disease was found to vary very greatly, 

 but in the majority of instances either sterilised milk or patent 

 foods of one form or another had been given. Of the total 



