As is well known, infants which
develop beriberi are almost always nursed and not bottle-fed, and show
signs of this disorder, although the mothers are in apparent health, and
give no clinical evidence of disease.
Turning to a consideration of _the artificially-fed infant_, there
exists a somewhat similar situation in regard to the occurrence of
scurvy on a diet of raw cow's milk. In almost all reports of this kind
the quantitative viewpoint is entirely disregarded, and little or
nothing is stated to indicate how much milk the infant consumed. And yet
this factor is of essential importance in interpreting the cause of the
nutritional failure. It is clear, for example, that if a baby receives
but eight ounces daily of raw milk--one-half the requisite amount--it
may well develop scurvy, notwithstanding the fact that the milk has not
been heated. In addition to the quantity, there are other factors which
play a greater or less rôle in the relation of raw milk to the etiology
of scurvy. It is no doubt of consequence whether the fodder of the cows
was rich or very poor in the antiscorbutic factor, and, accordingly,
whether the baby received what may be termed an "antiscorbutic-rich" or
an "antiscorbutic-poor" milk. Furthermore, the age of the milk must be
borne in mind, for we have found that even raw milk loses some of its
potency on becoming stale.[10]
[10] Moore raises the interesting question as to whether a diseased
condition of the cow may decrease the vitamines of the milk--whether a
certain outbreak of scurvy among guinea-pigs might have been due to
their having been fed on the milk of a cow suffering from experimental
streptococcus mastitis. If such proves to be the case, it would have an
important bearing on the question of scurvy and pseudo-scorbutic
conditions in nursing infants.
One of the mooted questions relative to the etiology of scurvy is the
rôle of heated milk, and more particularly of _pasteurized milk_. In
view of the vogue which pasteurization has acquired in the large
municipalities, especially in the United States, this aspect has assumed
increasing importance, and deserves detailed investigation.
Pasteurization has achieved so much in limiting the infectious diseases,
especially the diarrhoeal disorders of infancy, that it has come to be
looked upon as heresy to deprecate its virtues in any regard.
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