discharges its contents slowly. This retarded action in the dis- 
charging action of the stomach is to permit its gastric juices to act 
upon the casein in the fatty curds present. As a result, the next meal 
finds the stomach with a residue from the one previous, to which is 
added the increment just received. In this manner the gastric con- 
tents become progressively richer both in fat and proteicls. As this 
highly seasoned mass is poured out little by little into the duodenum 
and small intestine, it, in its turn, becomes encumbered with a food 
the problem of whose digestibility is beyond its resources. Gastric 
as well as intestinal digestion is well-nigh at a standstill: fermenta- 
tive changes take place, and then, in the language of the German 
investigators, the so-called “ 4 catastrophe ’ ensues.*’ 
This, of course, is an extreme case. Czerny has graphically delin- 
eated the symptom complex observed when the feeding of foods is 
persisted in whose energy quotients surpass the normal limit of the 
organism, especially when such excess consists of fat. An infant that 
has been thriving receives some new addition to its food. This may 
either be an increase in the quantity or an addition to the richness 
of its ingredients. For a while a remarkable gain in weight is ob- 
served. The infant, however, soon becomes restless, its sleep is light 
and broken. It seems somewhat nervous and becomes less active and 
playful. At the same time its keen appetite diminishes and it has 
to be coaxed to drink its food. Often 2 or 3 ounces will be left in the 
bottle or glass. The stools, hitherto of normal odor, color, and con- 
sistency, become pale-gray, hard, and dry. In fact, they are of the 
color and consistency of putty, and may be rolled' off the diaper with- 
out even soiling it. Their odor is strong and suggests decomposition. 
The urine becomes charged with ammonia salts and stains the diapers. 
Systemic effects are shown by the pallor of the child ; the tissues lose 
their firmness and solidity, becoming flabby and relaxed ; the child 
also fails to gain in weight on the same food or a greater quantity 
of the same food which has hitherto produced a gain in weight. A 
persistence in this course of feeding not only does not increase the 
weight, but occasions a loss. Two results follow the continued exhi- 
bition of such a diet. The body tissues waste, the belly distends with 
gas, and we have the atrophic or marantic child, or a gastro-intestinal 
catastrophe results with vomiting, diarrhea, fever, and prostration, 
accompanied by an inability to take cow’s milk for a period often 
extending into weeks. Such, then, are the symptoms in the more ag- 
gravated cases. In those more chronic the anorexia and constipation 
go hand in hand, the former and the latter being almost constant. 
Outbreaks of eczema are common, from small roughened patches on 
the cheeks to eruptions invading large areas. As the' child grows 
older the symptoms of rachitis are observed. 
