664 
the carbo-hydrates as a proteid saver, besides promoting free action of 
the bowels. 
And yet what better proof that fat is the cause of constipation could 
be adduced than by the following circumstance which T\ T alls a has 
observed in so many instances, viz, that whenever the symptoms of 
fat intoxication are manifest, as evinced by the characteristic stools, 
a diet of fat- free whole milk works like a specific in initiating normal 
intestinal action. 
The fifth principle, going hand in hand with the fourth, is likewise 
erroneous in basing the composition of the milk modifications offered 
on the age of the child— that is, to take them in so far that the weight 
of the child and the amount of the heat units necessary to nourish 
it and give it growth are not taken into proper consideration in this 
way. Moreover, only lately has the principle been recognized that 
food elements, if furnished even in trifling excess, instead of inuring 
to the benefit of the infant, have a way of reacting to his detriment. 
The following table, taken from a well-known text-book on pedi- 
atrics, can be used to further illustrate these points : 
Approximate schedule for milk modifications for various ages. 
Age. 
Fat. 
i 
Sugar. ; 
Proteid. 
Quantity at one 1 
feeding. 
Number 
of feed- 
ings in 
24 hours. 
Ounces. 
Grams. ; 
Premature infants 
1.00 
4.00 
0.25 
J_ 3 
7- 22 
12-18 
First to fourth day 
1.00 
5.00 
.30 
1 - U 
30- 45 
6-10 
Fifth to seventh day 
1.50 
5.00 
.50 
1 - 2 
30- 60 
10 
Second week 
2.00 
6.00 
.60 
2 - 2| 
60- 75 
10 
Third week 
• 2.50 
6.00 
. £0 
2 - Zb 
60-110 
10 
Fourth to eighth week f 
3.00 
6.00 
1.00 
2 1- 4 
75-125 
9 
Third month 
3.00 
6.00 
1.25 
3-5 
90-155 
8 
Fourth month 
3.50 
7.00 
1.50 
3J- 5b 
110-170 
7 
Fifth month 
3.50 
7.00 
1.75 
4-6 
125-185 
7 
Sixth to tenth month 
4.00 
7.00 
2.00 
5-8 
155-250 
6 
Eleventh month 
4.00 
5.00 
3. 00 
7-9 
220-280 
5 
Twelfth month 
4.00 
5.00 
3.00 
7-9 
220-280 
5 
Thirteenth month 
. 4.00 
4.00 
3. 50 
7 -10 
220-310 
5 
If, for example, we take from this table the formula advised for 
the second week — i. e., fat 2.00, sugar 6.00, proteids 0.60 per cent — we 
find such a ration furnishes a caloric value of 0.457 calories per gram. 
The total amount administered is 600 to 750 cubic centimeters a day, 
giving a caloric value of 274.2 to 342.75 calories per diem. Assuming 
that a healthy average child weighs 3,500 grams at 1 the beginning of the 
second week, the energy quotient required is 100 calories per kilogram 
of body weight. It will then require food supplying 350 calories a 
day properly to nourish it. 
a Loc. cit. 
