We see, however, that not only the lowest but the highest ration 
furnished by this table is less than its actual requirements. The ra- 
tion is also very poor in proteid in contradistinction to mother’s milk, 
which is normally higher in proteids during the first weeks than at 
other periods of lactation. Of course, the theory for this modifica- 
tion is that higher proteid would upset the digestion. This objec- 
tion can be no longer regarded as valid. This is not, however, a very 
serious disadvantage of this table. Under-feeding never caused 
serious gastro-enteritis, and as a consequence babies fed on this plan 
usually pass without digestive disturbance through the initial for- 
mulae, though they gain weight but slowly from them. 
It is when we turn to the percentages advised for older infants that 
the possibilities of danger are apparent. Taking the daily ration ad- 
vocated for the infant of 6 months, we find that the percentages of this 
ration are as follows : Fat 4.00, sugar 7.00, proteid 2.00 per cent. This 
gives a caloric value of 741 calories per kilogram, or 0.741 calories per 
gram. The daily quantity recommended varies from 930 to 1,500 
grams, giving a total daily caloric value of 689.1 to 1,011.5 calories. 
Supposing a 6-months-old infant to have attained the weight of 7,300 
grams (16 pounds), and requiring an energy quotient of 90, we see 
that the energy quotient furnished by the above diet varies from 92, 
or near the safety limit, to the dangerous figure of 134.8. 
Now, as long as everything is going well, and we have no scien- 
tific guide on which to base our calculations, the tendency is to give 
an artificially fed infant as much food as it will absorb within the 
indicated limits of the schedule. 
As the higher limit of 1,500 grams a day was being approached, 
a gratifying and remarkable 1 increase in the gain in weight would 
be observed. This, as Czerny tells us, is a significant sign that the 
income and the outgo are not correctly balanced and calls for im- 
mediate reduction in the energy quotient of the food. 
That this position is sound a little reflection will make clear, as it 
is evident that growth, being the result of anabolic effort on the part 
of certain organs, must necessarily have a certain maximum rate of 
increment beyond which we pass into the pathologic. In our hypotheti- 
cal instance, satisfaction at the child’s remarkable and unexpected gain 
in weight would further the inclination to continue with greater quan- 
tities of the food that has agreed so well with it. In this manner 
the physiological needs of the child having been long surpassed, the 
symptoms of over-feeding as previously described become evident, 
either the gastro-intestinal catastrophe or the anorexia, constipation, 
and continual recession in weight. 
In the case of the first outcome, withholding of the milk and ap- 
propriate treatment is instituted, with the result, however, that much 
