Upon examination of the roentgenograms it can be readily appreciated how a definite interference with the normal expansion is present. It is this, I think, which gives the peculiar form to the childs head.
The ophthalmoscopic examination showed a pallor of both optic nerves, the fundi otherwise normal.
Lecithin was ordered, one drachm of Fair childs solution given three times a day. This was continued for over two months with no apparent improvement. One grain of thyroid extract with one – half grain of the pituitary extract was given for the following three months with decided advantage. The stool became more regular and the scybalous character gradually lessened. The general condition, such as circulation, intelligence, and strength, improved. At this time the diet consisted of vegetable puree, such as baked potato, spinach, peas, and carrots.
The yolk of hard cooked eggs was given for its fat and lecithin content, and was well assimilated. Dentition, long delayed, made rapid progress; likewise the child, then at the age of three years, commenced to speak and also to walk. Vitaphos had been given in 22 grain doses three times a day with exceedingly good result. But my greatest reliance in this case has been on the persistent use of the internal secretions and the diet. The child hss been a source of considerable anxiety as the prognosis was hopeless fro the beginning, and various opinions given all agreed that nothing could be done.
Frances G., born November 27, 1916, was three months old when seen by me. Weighed 5 pounds at birth, 7 3/4 pounds when three months old. Was premature five weeks. Had had alternate feedings of breast milk and Nestles food. The infant was restless, had head sweating, and greenish stools containing mucus and occasionally yellowish – white casein particles. The circulation was stagnant; arms, legs, and face markedly oedematous. The urine contained albumin and traces of sugar. Nestles food was discontinued, and in its place skimmed milk 2 ounces, maltose 1 drachm, and water 3 ounces was given alternating with the breast.
The substitute feeding improved the stools and satisfied the infant, but did not increase the weight. Autolyzed yeast (endomycin) was ordered, 10 drops were given three times a day. This was continued, in all, about five weeks. The infant appeared brighter and gained in weight. The food was increased 2 ounce more very two weeks until 4 ounces of skimmed milk, 2 ounces of water, and 12 drachms of maltose were given. At six months the infant was weaned, and whole milk substituted for skimmed milk in the formula. The faulty metabolism of both fat and protein seemed to improve after two weeks of the Autolyzed yeast treatment; likewise the gain in weight was steady, the stools became more homogeneous, and contained less mucus and fewer curds.
When we feed food deficient in vitamin, be that the human breast or cows milk, such feeding will result in structural deficiency which may remain throughout life. The earliest manifestations and symptoms to watch for are profuse sweating, restlessness, irritability, wakefulness night and day, stationary weight or slow gain, and constipation with hard, dry, scybalous stools showing imperfect digestion. In these stools fat curds and casein lumps can frequently be seen.
This class of cases if seen early and the symptoms carefully noted will rapidly improve under the influence of restoratives such as the vegetable juices, especially those containing iron, like spinach, lettuce, salad, Romaine and Swiss chard; also small doses of cod liver oil, but it must be the pure oil, undiluted, 3 to 5 drops morning and evening, gradually increased. Autolyzed yeast in liquid form, or vitaphos in tablet or powder form, is an excellent restorative.
Milk to which is added the crushed yolk of hard cooked egg, or milk to which several teaspoonfuls of baked potato is added, can be given with advantage to correct the above – named symptoms. Orange juice should be given as early as the second month if these symptoms appear. When they are neglected, then such deficiency diseases as rickets and scurvy in a susceptible body usually result.
