222 MILK AND ITS HYGIENIC RELATIONS 



investigated the question of scurvy and had reached the conclusion 

 that changes of dietary were probably necessary. He reported 

 the occurrence of ten cases in breast-fed babies. 



The result of the discussion was summed up by Morse, who 

 concluded that there appeared to be nothing which could really 

 point to the production of scurvy by pasteurised milk. 



Comby (2), in 1915, quoted twenty-six cases of scurvy in 

 children, some of which had been previously fed on sterilised milk 

 or on proprietary foods, or other special preparations. He stated 

 that scurvy can be cured by the use of boiled milk and pointed out 

 the dangers of a too great similarity of diet. 



Further information upon the literature of Barlow's disease 

 can be obtained by consulting papers by Netter, Corlette, Schreiber 

 and Francois, Comby (i), Heubner (2), Bolle, la Fetra, and others. 



Rickets. The production of rickets by the use of heated milk 

 has been much discussed in recent years. The general experience, 

 however, which has now been gained as a result of the large infant 

 welfare centres in this and other countries, has tended to discredit 

 any belief in the production of rickets by the use of boiled milk. 



It may be of interest, however, to give a few facts connected 

 with this matter. 



Escherich, speaking in 1900, says : ' As regards the much 

 disputed question of rickets, in my experience it is hardly less 

 frequent in breast-fed babies than in bottle-fed ones. The worst 

 degrees of rickets are, however, only met with in the latter class.' 

 It may be mentioned that in the artificially-fed class Escherich was 

 dealing entirely with infants fed upon milk called by him ' sterilised/ 

 but which had apparently been subjected to prolonged boiling and 

 not strict sterilisation. 



Bresset, in the work on his consultation already referred to, 

 stated that rickets was extremely rare among the children attending 

 the consultation. 



Variot stated (in the work already referred to) that a few cases 

 which had been overfed or had received farinaceous food while 

 still too young had developed rickets. These cases occurred in 

 a total of about 3000. 



In the Berlin babies investigated by myself, it was shown that out 

 of the total number of infants (504) investigated there were sixty- 

 one cases where rickets appeared to be definitely developed and 

 ten doubtful cases. Of the sixty-one cases thirty occurred in the 

 breast-fed series and thirty-one in the boiled milk series. Too 

 much stress must not however be laid upon these figures, as the 

 children were in many cases not seen after the age of one year. 

 The incidence of rickets in Berlin is admittedly high among the 

 general population. 



Naish, in the work already referred to, says : ' I have followed 

 up considerable numbers of those fed on dried milk, and noted 

 the time at which independent walking commences ; this I have 



