594 MILK 



fall suddenly. As a rule there is no or very slight elevation in 

 temperature. 



Dyspepsia may set in after a disturbance in the weight balance 

 or it may occur in the case of a child previously healthy. The 

 food element primarily responsible for this form of alimentary 

 disturbance is apparently the carbohydrate, fat playing a second- 

 ary role. 



The treatment varies with the manifestations the child pre- 

 sents. If the dyspepsia is acute, the infant should be deprived of 

 food for from six to twelve hours and given only water or weak 

 tea and saccharin. After that it is best to put the infant on breast 

 milk if possible. If no breast milk is available the artificial feed- 

 ing should be resumed gradually. It should be less in amount 

 and strength than that usually required for the age of the infant, 

 and both the fat and the whey in the miUc shotild be reduced for 

 several days. If the vomiting persists, buttermilk or albumen 

 milk should be given, and if it is very severe, lavage should be done. 

 The question of catharsis in dyspepsia has been a widely dis- 

 cussed subject for a long time. Many pediatricians practice 

 catharsis in all cases of dyspepsia; others claim that catharsis by 

 calomel is contraindicated and catharsis by castor oil unneces- 

 sary. We have found that in most cases of dyspepsia no catharsis 

 is required. 



Intoxication. — ^A state of intoxication may follow a severe 

 dyspepsia or it may come on during the stage of decomposition. 

 A baby that gives a history of vomiting with several watery, 

 green stools a day may get into, a toxic state and present symp- 

 toms of drowsiness and coma. In such a state the temperature 

 is high and the respiration is labored, like that of an animal in- 

 toxicated with a large amount of acids. The stools continue 

 to be numerous and watery. The urine shows abnoi^mahties, 

 usually being highly concentrated and exhibiting the presence of 

 sugar, and often also of albumin and acetone. The blood shows 

 a leukocytosis. If the child does not improve, or if it does not 

 recover from its toxic state, death usually follows in a few days 

 or even in a few hours. ' 



Some pediatrists, notably Czerny, consider this condition an 

 acidosis. They base their claim on the character of the respira- 

 tion — its similarity to the labored breathing of a rabbit made 

 toxic with acids. Finkelstein and Meyer, however, explain the 

 condition as an intolerance to carbohydrates and salts. 



The treatment consists in the detoxication of the infant. 

 Starvation for from several to twenty-four hours is necessary to 

 give the gastro-intestinal tract a complete rest. All food should 

 be withheld from the patient and he should be put on a mixture 



