Am.  Jour.  Pbarm.  \ 
December,  1900.  J 
Substitute  Infant-Feeding. 
587 
the  water.  This  is  prepared  in  the  evening  and  placed  in  the 
refrigerator  over  night.  In  the  morning  the  water,  looking  like  thin 
tea,  is  removed  by  a  spoon  or  strained  off,  and  is  ready  for  use. 
About  a  tablespoonful  of  this  solution  can  be  thus  secured,  and  is 
very  active  in  diastase.  It  is  sufficient  to  dextrinize  a  pint  of  gruel 
in  ten  to  fifteen  minutes.  Preparations  of  diastase  are  made  by  a 
number  of  chemists — Forbes,  Parke,  Davis  &  Co.,  Horlick  and 
others.  There  is  now  obtainable  an  active  glycerite  of  diastase 
known  as  Cereo,  which  is  specially  made  for  the  purpose  of  dextrin- 
izing  gruels. 
Now  the  question  of  pasteurization — heating  to  1670  F. — or 
sterilization — -heating  to  212°  F. — arises.  It  should  be  remembered 
that  the  object  of  pasteurizing  and  sterilizing  milk  is  to  kill  the  bac- 
teria, and  in  that  way  make  the  milk  suitable  for  infant-feeding.  If 
the  milk  was  originally  clean,  cooled  immediately  after  being  drawn, 
and  kept  cool,  there  would  be  no  need  of  heating  the  milk  to  kill 
bacteria.  In  the  summer  time,  where  it  is  impossible  to  keep  the 
milk  below  6o°  F.,  it  is  best  to  have  it  pasteurized  as  soon  as  it  is 
received. 
It  is  often  recommended  that  lime-water  or  bicarbonate  of  soda  be 
added  to  milk  when  it  is  slightly  acid.  The  acidity  of  milk  is 
caused  by  bacteria  that  produce  lactic  acid.  If  the  acid  is  neutral- 
ized, the  bacteria  will  produce  more  acid,  unless  the  milk  is  either 
kept  cool  or  heated  to  destroy  the  bacteria. 
There  are  cases  constantly  arising  where  milk  must  be  withheld 
for  a  time,  or  given  only  in  small  quantities.  Here  is  where  the 
judgment  of  the  physician  may  be  put  to  a  severe  test.  The  symp- 
toms that  call  for  a  modification  or  a  change  of  diet  are  vomiting, 
colic  and  unnatural  stools.  A  brief  glance  at  these  conditions  may 
be  helpful  to  some  in  applying  dietetic  remedies. 
Vomiting. — When  vomiting  occurs  immediately  after  feeding,  it  is 
probably  caused  by  a  simple  distension  of  the  stomach,  and  less  bulk 
of  food  is  accordingly  indicated.  The  vomiting  that  occurs  some 
time  after  feeding  is  apt  to  be  caused  by  undigested  food;  the  rejec- 
tions are  frequently  highly  acid,  and  there  may  be  curds  and  mucus 
present.  Projectile  vomiting,  where  food  is  rejected  with  force,  is 
an  indication  of  brain  irritation. 
Colic. — Colic  may  be  caused  by  cold,  but  is  more  frequently 
induced  by  the  fermentation  of  indigestible  food. 
