﻿382 MUSGRAVE AND RICHMOND. 



takes food irregularly, followed occasionally by vomiting. Percentage feeding 

 instituted with, rapid recovery. 



Because of failure of breast milk this normal Si-pound baby was given sub- 

 stitute feeding at 3 weeks of age consisting of an "evaporated cream," prepared ac- 

 cording to the directions of the manufacturer. There was no improvement and 

 when the infant came under observation it was receiving a one-fourth dilution of 

 this milk plus 10 per cent limewater and 5 per cent milk sugar. Figuring from 

 our Table No. 15 we see that this baby was taking about as follows: fat 2.5 per 

 cent, sugar 9 per cent, and proteid 2.75 per cent. The proper percentages were 

 instituted here by simply combining a 38 per cent preserved cream with a proper 

 amount of the same excellent food the baby had been receiving, with the addition 

 of the necessary sugar and the changing of the limewater to a solution or 

 sodium citrate. 



The trouble with this patient as with the other and many more whom we 

 could enumerate, was the lack of proper proportions of the essentials in the food, 

 and this lack was largely due to the want of appreciation of what was necessary 

 and to a manufacturer's claims for the superiority of his milk. 



By proper adjustments of amounts of the various brands of sterilized, 

 pure cow's milk, evaporated or condensed milks and preserved and con- 

 densed creams, a fairly wide variation of percentages may be made and it 

 is in this way that we may obtain the best results from feeding preserved 

 milks. What is most needed on the part of manufacturers is the giving 

 of more accurate information concerning the composition of their foods 

 and their methods of preparation, with fewer statements about what they 

 will accomplish. Special results in special cases are more the result of 

 elasticity in the babies' metabolism than in any unique composition which 

 may be given to any one brand of cow's milk evaporated in vacuo. 



Chart No. 1, opposite this page, which has been prepared for us by Dr. 

 A. J. Cox, Chemical Laboratory, Bureau of Science, taken in conjunction 

 with Table Xo. 15, will help the physician in calculating his percentages 

 from the principal milks to be found in the Manila market: 



Explanation of Chart No. I. 3 — The fact that children of different ages 

 require milks of different composition for their proper nourishment, 

 makes it very desirable that we have some way of quickh' ascertaining 

 the proper mixture of milk and cream and its dilution. The old cut 

 and dried method is unsatisfactory and extremely slow because of the 

 great number of variable factors involved. 



The very close agreement between the analyses of all the brands of 

 pure, sterilized milks for sale on the Manila market makes it possible to 

 prepare a chart from which the amounts of lactose, water, milk, and 

 cream which will give the proper percentage of constituents in the final 

 product, may be calculated when any one of these milks and any standard 

 pure cream are used. The chart is prepared on the basis of a 38 per 

 cent cream, but as is explained blow if is equally well adapted for the 



5 By Dr. A. J. Cox. 



