729 
wrought in the composition of the body tissues and the constitu- 
tional symptoms would follow. 
In many of the cases of infantile scurvy caused by sterilized milk 
the formula used seems to have been the causative factor, i. e., low 
proteids or low proteids and high fat. Xow all such modifications 
are derived from the dilution of top milks and creams with water. 
This implies that the quantity of the mineral salts present in the 
milk is greatly diminished, as, in order to produce this relative pro- 
portion of fat and proteid, small amounts of these top milks and 
creams are diluted with large volumes of water. 
Thus a modified milk mixture of the following formula : Fat, 3 ; 
sugar, 6, and proteid, 1, is obtained by diluting 6 ounces of 10 per 
cent cream with 12 ounces of water and adding 1 ounce of milk sugar. 
This has at once the effect of reducing the mineral salts in this mix- 
ture to one-third the amount present in a similar amount of whole 
milk. When higher fat modifications derived from cow’s milk are 
used without increasing the proteid, or when the proteid percentage 
is to be reduced, a richer cream must be taken in smaller amount and 
diluted with a greater volume of water. On the other hand, I would 
attribute the occurrence of cases of scurvy which have been observed 
to result from the use of whole sterilized cow’s milk to the presence 
of an excessive amount of fat in the milk, which, by reason of the 
greater digestibility of sterilized milk, when compared to raw milk, 
was ingested without causing acute gastro-intestinal disturbance. 
It is easy to see, then, how a milk modification in which the min- 
eral salts are greatly reduced, or even a rich whole milk, which by 
virtue of its sterilization is thereby made easier of digestion, may, on 
the one hand either by deficient supplying of alkaline bases, and on 
the other by their excessive abstraction from the body for the pur- 
poses of saponification, produce in the long run the alteration of the 
body tissues and fluids which may result in scurvy. It may, how- 
ever, be objected that the proprietary foods and condensed milk, 
which are anything but rich in fat, are themselves the most prolific 
causes of infantile scurvy. 
This objection may be met by the fact that these are concentrated 
foods, and, for use, are diluted with large volumes of water. In the 
case of condensed milk, at least, this has the effect of reducing the 
salts far below the limit required by the body. Thus, condensed 
milk, when diluted with 6 parts of Avater, contains 0.17 per cent, with 
12 parts 0.10 per cent, and with 18 parts 0.07 per cent of these salts. 
These are the dilutions ordinarily used in the feeding of infants. 
Taking woman’s milk as a standard of infant needs in this respect 
in maternal nursing, at least, we find, according to Von Bunge, that 
potassium and sodium are by far the preponderating alkaline bases 
