VI. DIARETICEA.—A diarrhcea which has as a cause simply a wrong propor tion in the food is very rare. Frequent almost normal movements, however, may be due to too high fat. Generally the diarrhoea is due to acute or subacute in digestion in the intestines.
Buttermilk used with success for years as a food for infants. He adds rice and barley to it, and heats it for twenty-five minutes, after which Ile adds beet-sugar. As a result of the use of buttermilk, acute and chronic gastro enteritis disappear and rachitis is seldom seen. The lactic acid does no harm and but very little free hydrochloric acid re• sults. No case of infantile scurvy has ever appeared. It is not indicated dur ing the first month of life. Vomiting grows less or stops entirely, and diar rhoea is never caused by it. When con stipation exists, or the child ceases to gain in weight, cows' milk may be added to the buttermilk. Teixeira de Mattos (Jahrbuch f. Kinderh., Jan., 1902).
Lauded by the Dutch physicians and prepared according to their prescrip tions, buttermilk is a good therapeutic aliment for infants affected with acute or chronic diseases. The buttermilk used in the author's experiments con tained cream rendered acid by the lactic acid fermentation. and freed from the greater part of fatty matter by the ex traction of butter. It was delivered as fresh as possible and the cream exposed no longer than twenty-four hours to the lactic acid fermentation. IL was then treated as folli»vs: To a litre of butter milk there were added 25 grains of wheaten flour and 35 grains of cane sugar. It IVI1S UO1 pit tO 11011 for at least two minutes, mixed continually, and allowed to boil over three or four times. It was then placed in bottles previously sterilized in boiling water, stoppered with sterilized corks, and placed in the refrigerator. Before serv ing it WaS raised in the water-bath to the body-temperature. Thus prepared, buttermilk seems to represent ti priori no less than the equivalent, from the chemical standpoint, of the ideal nour ishment of the infant. It is well borne sometimes after the acute cris.es of dys pepsia and diarrlicca with vomiting. Employed as an aliment and as a rem edy, it can absolutely save lives of in fants attacked with chronic dieases of the stomach and intestines. As to its
-utility when employed as a food for a long time, it is not possible to say nail a greater number of observations have been made. Neither rickets nor scurvy has been observed following its pro longed use. A. Baginsky (Revue d'Hyg. et,Med. Infantiles, Oct., 1902).
Series of clinical tests of buttermilk as a food for 119 infants of nursing age. The milk used was recovered from sour cream, and contained 2.5 per cent. of albumin, 0.5 to I per cent. of fat, and from 3 to 3.5 per cent. of sugar. The acidity equaled 7 cubic centimetres (11/4 fluidrathms) of normal NaOH for each 100 cubic centimetres (3 1/, flitidounces) of bnttermilk. The milk should be used within twenty-four hours after churn ing, and must be obtained from a re liable source. The ordinary buttermilk of the shops is unclean and dangerous. The buttermilk used in Hailer's clinic is prepared as follows: Fifteen grains (1 gramme) of wheat-ilour arc stirred tip with a tablespoonful of cold buttermilk; the remainder of the buttermilk is then added, together with 2 ounces (60 grammes) of sugar. This preparation is slowly heated, being meanwhile con stantly stirred; the milk is allowed to boil up in about fifteen minutes, and is then poured into previously sterilized bottles, closed with rubber stoppers. Further sterilization is unnecessary. The nutritive value of this mixture it, very high, being 714 calories per litre. Most infants readily accept this food, either alone or alternately with "malz suppe" or with human milk. The stools of infants so fed are normally of mod erate volume, slight odor, neutral or slightly alkaline reaction, homogeneou.s, and yellow. The absoution which oc curs is estimated at DO per cent. of albumin and 1J3 per cent. of fat. Butter milk was tested with satisfactory re sults as the first food given after acute digestive disturbances. Among 119 eases the results of buttermilk feeding were satisfactory in S5 instance.s. Of the 34 infants who did not thrive on this diet, only 4 were successfully nourished b3., other means; 30 failed to do well on any other diet., several going. into de cline even when intrusted to wet-nurses. In large clinies the low price of butter milk is an important consideration. B. Salge (Jahr. f. Kinderh., Bd. lv, S. 1).