724 
7,300 grams (16 jDOimds), 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. 
Xow, 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 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 imme- 
diate reduction in the energ}^ quotient of the food. 
That this position is sound a little refiection 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 hypo- 
thetical instance, satisfaction at the child’s remarkable and unex- 
pected gain in weight would further the inclination to continue with 
greater quantities of the food that has agi'eed so well with it. In this 
manner the physiological needs of the child having been long sur- 
passed, 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 
valuable ground is lost, and we have a child who perhaps for weeks 
can not take any form of cow’s milk at all. 
In the second, the results may vary. The digestive disturbances 
are, as a usual thing, erroneously attributed to the cow’s milk pro- 
teids. The constipation may be regarded as the result of a lack of 
fat, which may be added to a diet already overcharged with this, and 
a gastro-intestinal crisis definitely precipitated. 
We must, therefore, regard the percentage system of feeding as 
based upon conclusions that are incomplete and the result of clin- 
ical observation alone, a form of observation that is prone to lead to 
inferences incorrectly grounded in fact. Without deprecating the 
skill and care used in Avorking out these formulae there is occasion 
for regret that until very lately, in the belief of the complete scien- 
tific accuracy of our methods, we have failed to undertake any obser- 
A^ations for ourseh^es as to the nutritiA^e requirements of infants, and 
the actual digestive absorption that takes place in respect to the vari- 
ous constituents of human and other milks in the infantile digestive 
tube. We see by the foregoing that the whole question of the arti- 
ficial feeding of infants may be reduced from a condition of extreme 
complexity, based upon the incomplete data of clinical observations. 
