Care and feeding of infants and children; a text-book for trained nurses . on high fat mixtures of cows milk, not infrequentlysuffer such damage to the digestive apparatus that, in spite offairly large amounts of food, they continue to lose weight untilsuch an extreme degree of emaciation is reached that death oftenresults, apparently from starvation (Figs. 67 and 68). Inherited Weakness.—Many of these children are bornunder unfavorable conditions, the parents are not vigorous andmay be suffering from the effects of latent tuberculosis orsyphilis. At autopsy some of these infants are found to
Care and feeding of infants and children; a text-book for trained nurses . on high fat mixtures of cows milk, not infrequentlysuffer such damage to the digestive apparatus that, in spite offairly large amounts of food, they continue to lose weight untilsuch an extreme degree of emaciation is reached that death oftenresults, apparently from starvation (Figs. 67 and 68). Inherited Weakness.—Many of these children are bornunder unfavorable conditions, the parents are not vigorous andmay be suffering from the effects of latent tuberculosis orsyphilis. At autopsy some of these infants are found to havetuberculosis. In some, ulcers of the duodenum are found, butwhether as cause or effect is not yet known. Prognosis.—In the acute form, the prognosis is usually goodwhen due to simple starvation, and all that is required to bringabout a cure is to supply a proper amount of breast milk. Thosedue to obstruction at the pylorus will require the appropriatetreatment, either medical or surgical. This has been describedunder DISEASES OF XUTRITIONFig. 67 147. Fi<;. 67.—Simple atrophy or marasmus in child eight months old. (St. Paul City and County Hospital.)Fk;. f««.—Same case after three months of proper feeding and care. (St. Paul City and County Hospital.) The chronic cases are the ones which tax the ingenuity andpatience of all concerned. Tki2.\tment.—When the atrophy is due to the food, theoffendin<^ clement—whether fat, sugar or salts—must Ijc de- 148 CARE OF INFANTS AND CHILDREN termined and eliminated. Even when these cases are placedupon a proper diet they must pass through a period of repairwhich may require several weeks or months before any markedimprovement may be noticed. The securing of at least somebreast milk is of vital importance. The bowels require special care, as the markedly atrophicmuscles have not sufficient force to produce normal evacuation.
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