MILK IN ITS RELATION TO INFANT FEEDING 595 



of water and saccharin. After the starvation period is over 

 feeding may again be resumed, but very gradually. The best 

 food to begin with is breast milk in small quantities, given at 

 short intervals, say 1 ounce every two hours. If the child vomits 

 the breast milk, it should be given in diluted form. If no breast 

 milk is available, "Eiweiss" milk of Finkelstein should be given. 

 Eiweiss milk is prepared in the following manner: 



To a quart of whole milk heated to 98 or 100 F. 2 level table- 

 spoonfuls of chymogen (pepsin) powder is added. This is brought 

 to a temperature of 107 F., at which it is kept for fifteen to twenty 

 minutes until the milk has all been coagulated. The mixture is 

 then put into a muslin bag which is suspended from a hook to 

 drain off the fluid portion of the milk. The curd remaining is 

 rubbed through a copper hair strainer three times or it is churned 

 through a meat-grinder three times. To this is added a pint of 

 buttermilk and enough flour to make up the required percentage 

 of carbohydrates. The entire mixture is then boiled for ten min- 

 utes, being rubbed constantly, but not stirred. 



Some carbohydrate should be given with the albumen milk 

 from the beginning to supply the necessary carbohydrate require- 

 ment. As a rule, a 2 per cent, flour ball is a, good proportion with 

 which to start. After the state of intoxication is over the amount 

 of carbohydrate should be gradually increased. After the diar- 

 rhea has been checked and the stool becomes clay colored the al- 

 bumen milk should be discontinued and the patient put on a 

 plain milk formula. 



Decomposition, which the older physicians termed "maras- 

 mus" or "atrophy," constitutes a condition of emaciation in which 

 all the body functions of the child are below par. Decomposi- 

 tion, which is rarely primary, usually comes on as the result of 

 repeated dyspepsia that wastes the body of the infant. 



Decomposition presents a picture that is unmistakable an 

 emaciated condition of the body, a flabbiness of the skin, which 

 looks ashen gray in color, and a subnormal temperature. The 

 child in a state of decomposition is restless and refuses to take 

 food. The character of the stool is not uniform, generally being 

 hard. Often, however, there is an interchanging diarrhea with 

 the constipation. The fat in the stool is often greatly increased, 

 a condition known as "fat diarrhea." A differential diagnosis 

 must always be made between chronic wasting due to other con- 

 stitutional conditions and that due to alimentary decomposition. 



The treatment of decomposition consists in increasing the 

 child's tolerance for food. No child with decomposition should 

 be starved for any considerable length of time. If it has been 

 artificially fed it should be put on breast milk given in small doses 



