720 
are dense and heavy, and show a remarkable tendency to coalesce and 
stick together. This is well brought out by attempting to pour out 
the curded milk from each bottle. Now, the curded skimmed milk 
pours out very easily, and, on examination, the curds are distributed 
throughout the whey in light flocculent masses, while in the case of 
the milk rich in fat, pouring out will frequently be interrupted by 
large lumpy curds sticking in the narrow neck. Agitation of the bot- 
tle to break them up merely seems to increase their adhesive powers, 
each lump receiving further accretions from the particles floating in 
the neighborhood. 
We can easily, then, predict the events that take place when a milk 
rich in fat is acted upon by the gastric juices in the infant’s stomach. 
In fact, this action of fat in making curds, large and indigestible by 
reason of their excessive fat content, has long been known to dairy- 
men, as they are well aware of the fact that Jersey cows often can not 
nurse their calves by reason of the excessive richness of their milk. 
And yet one would never for one moment suppose, under normal cir- 
cumstances, that the casein of cow’s milk is ever indigestible per se to 
the calves for which it is intended. 
In the case of the human infant, if the milk be too rich it is vom- 
ited. If it is just rich enough to produce a curd with a fat content 
greater than it should have, peristalsis is checked and the stomach 
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 proteids. 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 
