The diseases of infants and children / by J.P. Crozer Griffith and A. Graeme Mitchell.

  • Griffith, J. P. Crozer (John Price Crozer), 1856-1941.
Date:
1937
Catalogue details

Licence: Public Domain Mark

Credit: The diseases of infants and children / by J.P. Crozer Griffith and A. Graeme Mitchell. Source: Wellcome Collection.

    117/1210 (page 95)
    There are several liquid malt extracts such as Borcherdt’s, Maltine, Kepler’s, Bur- rough’s, Lilly’s, Loeflund’s, Parke-Davis, Denver, and Hoff’s; which, however, are not ordinarily employed as additions to milk. These extracts vary in composition, but have approximately 40 to 60 per cent maltose and 5 to 15 per cent dextrin. In some of them dextrose is present varying from 12 to 15 per cent and the percentage of pro¬ tein material is only about 4 or 5 per cent. In most of them a diastatic ferment is present and they contain vitamin B complex. The various malt-soup preparations will be referred to later (p. 106). There is no question that sugar is one of the most digestible elements in milk, and while it usually is added to make the total percentage of the mixture about 5 to 7, it can be employed under certain conditions in' much greater concentration (p. 97). Starch.—Starch is a useful carbohydrate in those cases where a high percentage of the latter is required. There is, however, no reason to give barley water or other amylaceous decoctions as a routine measure. Although young infants can digest starch it is not required in the diet of the healthy child until about the age of five months, by which time a cooked cereal fed with a spoon answers the purpose. Sterilization.—The effect of heat upon milk has already been described (p. 82). The chief practical advantage of subjecting it to boiling (212° F. [100° C.]), is that this, or other forms of heating to this temperature or higher, as in commercial evaporation or drying, prevents the formation of large, tough curds in the stomach and thus makes the milk more diges¬ tible. The effect upon bacteria has already been considered (see pp. 82, 86). Any inhibition of vitamins brought about by heating is unimportant, inasmuch as these should be given in some form in addition to the milk mixture (pp. 115, 128). Pasteurization.—This term had its origin in the employment by Pasteur of a temperature of less than 212° F. (100° C.) for the preservation of wine. As applied to milk it consists of subjecting it to a temperature of less than boiling, one of from 140° to 165° F. (60° to 74° C.) being ordinarily recommended, and the heat maintained for from thirty to sixty minutes. The lower the temperature the longer the time the milk should be subjected to it. It produces little if any change in the milk chemically, but the pathogenic bacteria are killed as well as many of the nonpathogenic ones. After pasteurization the milk should be cooled rapidly and kept cold in order to inhibit subsequent bacterial growth. Commercial pasteuriza¬ tion is today so closely guarded by the Health Authorities in most com¬ munities that a grade of pasteurized milk may be obtained which is safe under most conditions for infant feeding, and home pasteurization is, there¬ fore, seldom necessary. Electrical Treatment.—This will destroy certain pathogenic bacteria but the method has not been employed to any extent. Laboratory Modification of Milk.-—In a few cities are so-called “milk laboratories” to which the physician merely sends a prescription calling for the various proportions of the milk elements he wishes, the total number of bottles, the amount of food for each, the nature of the diluent, and any other requirements desired. If the food is to be pasteurized or sterilized, a starchy addition to be dextrinized, fermentation by lactic acid bacilli to be produced, or any other change made, this is specificed in the prescription. Home Modification of Milk.—Having decided on the amounts of milk, sugar and diluent to be used the physician must give the mother or nurse clear, concise, and preferably written directions. It is of advantage to employ printed slips. Articles Required in Preparing the Food.—Bottles.—These should be of well-annealed glass to prevent breaking when exposed to heat. They should be narrow and cylindrical, since they occupy less space when of