658 
be as irrational as the general use of one formula. Each infant is 
a law unto itself, and whether it is to receive heated or unheated milk 
must depend entirely upon the conditions, especially the season of the 
year and the quality of the milk available. 
Scurvy . — Scurvy occurs in children fed both upon pasteurized and 
unpasteurized milk ; it may even occur in breast-fed infants. Scurvy 
is at most a comparatively rare disease. As there are countries where, 
despite sterilization, scurvy practically never occurs, the cooking of 
the milk can not be the only cause of this disease. It is not a new dis- 
ease, but was described in infants for the first time only a decade ago. 
Even at the present time the disease is often not recognized by clini- 
cians. F ormerly the condition was called “ acute ricketts ” (Moeller) . 
In Germany we are told the disease is either exceedingly rare or not 
recognized. For a long time the French claimed that the disease did 
not exist among them, but during the past two or three years there 
have been occasional reports of isolated cases (better). 
The disease was first studied by English clinicians and we are es- 
pecially indebted to Barlow, who, after a study of 11 cases with post- 
mortem results of 2, showed the essential features of the disease and 
gave it the name of scurvy. It is often spoken of as Barlow’s dis- 
ease,® or the Moeller * 6 -Barlow disease. 
We do not know whether scurvy has increased greatly during the 
past twenty years, or whether our more precise knowledge of the dis- 
ease has made this apparent. Those who believe the disease is in- 
creasing attribute this fact to the use of dried proprietary infant 
foods and the increasing use of heated milk. 
The proper treatment of infantile scurvy gives almost miraculous 
results. “ Within a few hours a pitiable, suffering little paralytic 
is transformed to a contented baby waving its arms and legs in the 
sheer joy of living.” This may be simply brought about by the use 
of fresh milk, fruit juices (orange, grape, or pineapple), beef juice, 
egg albumen, or puree of potato, according to the child’s digestive 
capacity. Scurvy is thus not only readily preventable, but amenable 
to treatment, and it would seem that those who have to choose be- 
tween the use of badly contaminated milk, with its serious conse- 
quences, and the remote possibility of scurvy as a result of pasteuriza- 
tion, should not hesitate long in the choice. 
I have made a careful compilation from the literature of the re- 
sults of raising children upon heated milk, and find hundreds of in- 
stances recorded, especially by French observers, to the effect that 
children flourish well upon heated cow’s milk and without the pro- 
° Barlow: Med. and Chir. Transactions, London. Yol. 66, p. 83. 
& Moeller: Akute Rachitis. Konigsberg. med. Jahrb., Bd. I (59), and Bd. 
Ill (62). 
