586 
Substitute  In fant-Feeding. 
J  Am.  Jour.  Pharm. 
I   December,  1900. 
can  be  brought  at  home,  and  is  sufficient  for  the  vast  majority  of 
cases.  The  proper  percentages  for  each  child  are  obtained  by 
increasing  or  decreasing  the  richness  and  the  dilution  of  the  top 
milk.  What  is  needed  in  a  given  case  is  a  dilution  of  cow's  milk 
that  will  agree  with  the  baby  we  are  trying  to  feed,  rather  than  the 
procuring  of  figured  percentages.  By  this  method  every  physician 
can  vary  the  strength  of  the  milk  in  a  sliding  scale  by  directing  the 
number  of  ounces  to  be  dipped  out  of  the  bottle  of  milk,  and  thus 
tentatively  reach  the  strength  that  is  suitable  for  the  infant's  diges- 
tion. 
For  every  twenty  or  twenty-five  ounces  of  food,  add  one  ounce  of 
sugar,  in  order  to  bring  this  element  up  to  the  proper  proportion. 
One  part  of  sugar  to  20  parts  of  food  yields  5  per  cent.;  to  25  parts, 
4  ;  to  33  parts,  3  ;  to  50  parts,  2  per  cent.  An  even  tablespoonful 
of  granulated  sugar  equals  half  an  ounce  approximately,  and  one 
scant  teaspoonful  equals  a  drachm.  Half  again  as  much  milk  sugar 
equals  the  same  weights. 
The  next  important  step  is  to  get  the  cow's  milk  as  nearly  as 
possible  in  the  same  physical  condition  as  mother's  milk.  The 
diluent  I  prefer  to  use  is  a  wheat,  barley  or  oatmeal  gruel,  the  starch 
of  which  has  been  digested  or  dextrinized  by  the  action  of  diastase. 
A  heaping  tablespoonful  of  flour,  made  from  a  cereal,  is  boiled  with 
about  a  pint  and  a  half  of  water  for  fifteen  minutes.  It  is  then  removed 
from  the  stove  and  set  in  cold  water  for  about  three  minutes  to  cool 
it.  When  it  is  sufficiently  cool  to  taste,  a  teaspoonful  of  a  prepara- 
tion of  diastase  is  added,  which  renders  the  gruel  thin  and  watery. 
This  makes  about  a  pint  of  gruel,  containing  the  starches  in  soluble 
form,  while  the  cellulose  or  skeleton  of  the  cereal  acts  as  a  most 
effective  attenuant  of  the  curd.  These  digested  gruels  render  the 
milk  curds  porous,  and  also  provoke  the  secretion  of  the  digestive 
juices.  As  diluents  they  are  a  great  improvement  on  water.  Most 
of  the  thick  malt  extracts  are  sufficiently  active  in  diastase  to  pro- 
duce the  desired  effect.  The  writer,  however,  prefers  the  employ- 
ment of  diastase  itself,  without  any  of  the  other  malt  ingredients,  as 
being  both  speedy  and  efficient.  It  can  either  be  produced  cheaply 
at  home  or  purchased  at  the  nearest  drug  store.  A  simple  decoc- 
tion of  diastase  may  be  made  as  follows :  A  tablespoonful  of  malted 
barley  grains  is  put  in  a  cup,  and  enough  cold  water  added  to  cover 
it,  usually  two  tablespoonfuls,  as  the  malt  quickly  absorbs  some  o 
