ARTIFICIAL FEEDING 
OF 
INFANTS. 
BY 
CYRUS EDSON, M.D., 
(Sanitary Superintendent, Board of Health, 
New York.) 
IN “THE DOCTOR OF HYGIENE.” “ARTIFICIAL FEEDING OF INFANTS.” 
BY CYRUS EDSON, M.D., SANITARY SUPERINTENDENT, 
BOARD OFj HEALTH, NEW YORK CITY. 
Of course, the best food for an infant is mother’s 
milk, but it is not always possible to use this: First, 
because the mother may be unable to supply sufficient 
nourishment to sustain the child. Second, because the 
mother’s milk is not of proper composition and does not 
agree with the babe. Third, because wet nurses are 
difficult to obtain and may be objected to not alone on 
account of the two foregoing reasons, but also on ac- 
count of the danger that they may transmit disease to 
the suckling. 
It becomes apparent every year that fewer mothers 
are able to properly nourish their offspring, a condition 
that is being effected by modern civilization. 
The problem of proper infant treatment therefore 
becomes more and more important, and is one of the 
most perplexing that medical men have to deal with. 
The natural substitute for mother’s milk would be 
cow’s milk as it is most easily procured, and as it con- tains all the elements necessary to support and nourish 
human life. The reason that cow’s milk is not a perfect 
substitute for human milk and is not adapted to the 
purposes of the latter, is, because the two differ materi- 
ally in composition. Another reason might also be 
justly advanced, cow’s milk that has not been sterilized 
may carry germs of disease, particularly those of tuber- 
culosis, and may thus infect the child whose delicate 
system affords a most excellent nidus for the develop- 
ment of such germs. 
Few persons realize the very great difference that 
exists between the chemical and physical compositions 
of cow’s and human milk. Without going too deeply 
into the chemistry of the lacteal fluid we may say that 
human milk is decidedly alkaline in reaction, while the 
milk of the cow is acid. Then, too, human milk con- 
tains more sugar and less albuminoids than does cow’s 
milk. But not only is the difference of albuminoids 
one of quantity, the latter in human milk form in the 
stomach, when acted on by the gastric juice, a coagulum 
which is soft and flocculent and consequently easily 
digested. 
On the other hand the albuminoids in cow’s milk 
coagulate into hard firm masses that require consider- 
ible muscular exertion on the part of the stomach to 
break up and digest them. This fact is an important 
one in the etiology of infantile diarrhcea. The delicate 
stomach of a child is often unable to cope with the hard 
indigestible curd, and the latter contains, when it has 
not been sterilized, the germs of putrefaction. These germs find in the weakened stomach every condition 
that is favorable to their rapid development. The curd, 
consequently, instead of being digested is putrefied and 
the poisonous products of the latter process cause an 
inflammation that is often fatal in its results. If, as 
may be the case, the milk contains the bacillus of ty- 
phoid fever, or that of dysentery, or that of Asiatic 
cholera, then either of the three diseases is apt to follow. 
There is no surer way of implanting the infectious 
diseases I have mentioned than through the medium of 
infected milk. But, you ask, how can milk be infected 
with such diseases? Very easily; milkmen are pro- 
verbially dishonest. They frequently water their 
wares, and they are by no means fastidious as to the 
quality of the water used by them for the purpose. I 
have found frogs, small eels and water-snakes in milk 
brought into this city. 
Some one has called the cow “ the curse of mankind ” 
because of the part she plays in the spread of tubercu- 
losis. I am inclined to believe he is right. To prevent 
the tough firm curding of cow’s milk various methods 
have been devised—attenuation by adding water is re- 
sorted to and substances such as barley are added. 
These act mechanically on the separation of the casein. 
But all these methods have been found to be only par- 
tially successful. Sometimes pancreatin is used to par- 
tially digest the albuminoids of cow’s milk and to thus 
render them more like those in human milk. 
The objection advanced against this is that the opera- 
tion of artificial digestion is a delicate one, requiring expert knowledge and experienced manipulation, and 
that it cannot be left to the mother or nurse. At one 
time the process may be carried too far, and the milk 
is bitter and unpalatable, at another it is not carried far 
enough to be of any practical use. 
PREPARED FOODS. 
Many prepared foods are offered to the medical prac- 
titioner, each claiming special advantages. 
As the physician is usually unable to personally ex- 
amine these foods, to determine their composition, he 
must rely more or less on the statements of the manu- 
facturers, and test such foods by actual practice. 
In using prepared foods very great care should be 
taken at the outset to see that they are in good condi- 
tion, that no deterioration has taken place through in- 
fection with the germs of putrefaction or of disease. 
We can only be certain in this respect of those foods 
that are delivered to us in hermetically sealed packages ; 
the contents of which, when milk has been used, having 
been sterilized before packing. There is little doubt 
but that much harm has been done by the use of par- 
tially spoiled foods. 
It has been quite positively settled that an infant 
under seven months old cannot digest starchy food. 
The salivary glands are not yet properly developed, and 
the secretion of Ptyalin, the ferment of the saliva which 
acts on starch, does not exist until after the above age. It would naturally seem then that an all milk food 
would be the only one to use. As far as I am aware 
Reed & Carnrick’s Lacto-Preparata is the only food of 
this kind offered to the Medical Profession or public, 
and from what I know of its composition, its prepara- 
tion and the results obtained by its use I am justified in 
saying that it is a most excellent substitute for mothers’ 
milk, and is the safest to use during epidemics of 
Typhoid Fever, Cholera Infantum and Asiatic Cholera. 
The milk used in Lacto-Preparata is selected with 
great care, the dairies being under constant supervision. 
The milk is run through centrifugal machines which 
not only remove the cream, that constituent which 
would cause deterioration of the product on keeping, 
but which also remove all foreign particles, thoroughly 
cleansing the milk, so to speak. 
The cream later on is partly replaced with purified 
cocoa butter which has been found by experiment to 
be as digestible as milk-fat and of equal nutritive value ; 
moreover it does not spoil. 
The mixture of milk and cocoa butter is now made 
alkaline with lime-water, then sterilized, evaporated to 
dryness, ground and packed in hermetically sealed 
sterilized cans. 
The same firm produce another food, adapted to the 
use of older infants and of invalids, called Carnrick’s 
Soluble Food. It is prepared similar to the Lacto- 
Preparata, but contains about one-half (Yz) its bulk of 
dextrinized flour. 
There is only one word of caution that must be given concerning the artificial feeding of infants; it is this: 
Watch carefully the condition of the child ; if its flesh 
becomes flabby and it does not seem to thrive as it 
ought, try the effect of small doses of a reliable emul- 
sion of Cod Liver Oil. It is possible that the system 
needs a little more fat than it is getting in its food. 
No prepared food, as far as I know, contains as much 
fat as the one recommended in this paper, but it is im- 
possible to prepare a palatable food that will keep and 
which will not be open to more serious objections than 
a slight deficiency in fat. 
Cyrus Edson. Kay Printing House. 149-153 Leonard Street. New York.