ALLEGED PRODUCTION OF BARLOW'S DISEASE 219 



continual suasion being applied to induce the child to take its 

 nourishment. 



In 1903 a paper was given by Heubner, who points out that 

 in his experience the number of cases of Barlow's disease had 

 increased very greatly of recent years. He quoted sixty-five cases 

 of the disease, details being given of fifty-five of these cases. The 

 method of feeding was as follows : 



Thirteen had received good milk from various sources, usually 

 given raw. 



Twelve cases had also received good milk which was sub- 

 sequently heated in the Soxhlet apparatus for fifteen minutes. 



Nineteen cases had been fed on pasteurised milk, subsequently 

 boiled in the home. 



Seven had received patent foods or condensed milk. 



Four had received starchy foods. 



An animated discussion followed Heubner's paper, in the 

 course of which Neumann (2) stated his opinions, which have been 

 already dealt with. Finkelstein quoted thirteen cases which had 

 occurred in the previous eighteen months and gave details. He 

 stated that of the thirteen cases five had received starchy food, but 

 that the disease was cured even when the starchy food was continued, 

 raw milk being given in addition. In seven cases milk had been 

 given which was already pasteurised and then again heated in 

 the home. In two of these cases it had only been boiled for five 

 minutes in the home. In one case it was especially desired to 

 avoid the occurrence of Barlow's disease in a child which had to 

 be artificially fed, and the milk was given only just boiled, and 

 fruit juice was added throughout the entire period of feeding. 

 In spite of this precaution the child did develop scurvy, which, 

 however, subsided under treatment, the details of which are not 

 given. 



Schultze stated that he had recently seen a good many cases, 

 but in practically all of them the milk had been pasteurised by the 

 dairy and subsequently again in the home in a Soxhlet apparatus. 



Ritter stated that the increase in Barlow's disease in Berlin 

 had begun since 1900 and was, he believed, due to the introduction 

 of sterilisation. In the cases seen by him the length of heating 

 varied from five to forty minutes, and out of twenty-two cases 

 the milk had been heated for twenty minutes or more and other 

 foods had also been given. 



In the course of the discussion it was pointed out that the 

 cases did not occur among the poorer population, but were mainly 

 among the population whose social circumstances were good, 

 and where every care was taken in the preparation of the 

 infants' food. 



Variot, in 1904, issued a report of his infant consultation at 

 Belleville, near Paris. At this consultation the artificially-fed 

 children received milk which had been heated to 108 C. Variot 



