238 DISCUSSION. 



determined. Its position is comparable with that of malaria before 

 Laveran's discover)- of the parasite. 



In view of this, would it not be better to retain the native names of 

 suba or taon for the condition described by McLaughlin and Andrews 

 at least until such time as the etiologic agents and clinical picture are 

 made more definite? 



The hypothesis that a fault)' or disturbed metabolism is the etiologic 

 factor in this group of cases might be open to some criticism, at least in 

 the light of our present knowledge. This is particularly true as to the 

 separation of breast-fed from artificially fed children. Experience in 

 hospital wards and clinics has shown that while practically all Filipino 

 children are fed from the breast, particularly vicious forms of artificial 

 feeding also are at a very early age made to supplement nature's method. 

 Again, it should be mentioned that numerous analyses of mothers' milk 

 taken from the class of people under discussion and analyzed by Bliss, 

 Richmond, 1 Bacon and others of the Bureau of Science have not shown 

 abnormalities in the composition of the milk which would indicate that 

 it is responsible for a sudden acute, fatal disease. 



I would also like to call attention to the fact that tuberculosis is ex- 

 tremely prevalent among nursing Pilipina mothers. 



Dr. Francis Clark, medical officer of health, delegate from the Govern- 

 ment of Hongkong. — I believe this to be one of the most interesting 

 papers which has been read. The question of infant mortality frequently 

 arises in the Far East, and at least two-thirds of the natives born die 

 within the fhst year. The entity described by Doctors McLaughlin and 

 Andrews would suggest the formation of commissions and of systematic 

 inquiries and researches in order further to elucidate the source of infant 

 mortality. ■ Although such commissions have existed, up to the present 

 time they have borne but little fruit. Most careful research has failed 

 to disclose the real causes of death in many instances. I believe the ( 

 suggestion that many of these deaths are nutritional to be an original one 

 and it opens a new field for research. I believe it to be premature to 

 term this pathologic entity "beriberi." We may regard the disturbances 

 as nutritional without designating them as beriberi. They are perhaps 

 due to nonsufficiency of phosphorus or salts. Doctor Musgrave tells us 

 that in general the milk furnished by the nursing mother is much the 

 same as it is in more temperate countries, but perhaps the content of the 

 milk in salts, and their nature, should be more fully investigated. 



Dr. Isaac W. Brewer, Medical, Reserve Corps, United States Army. — 

 I have to a certain extent investigated the mortality among infants 

 under one year in the Island of Cebu and have found it to be between 

 16 and 20 per cent. In that island T found a number of children fed 



1 This Journal, Sec. B (1907), 2, 361. 



