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lime from combination with the casein and sub- stitutes soda. Casein in combination with soda has none of the curding properties of fresh milk and milk so treated remains perfectly fluid in the presence of strong rennet ferments. Peptonizing milk also prevents the formation of curds. We rarely use peptonized milk as a steady diet, but only where it is indicated. It is important that we should learn to order alkali additions to. milk, or sodium citrate, only when they are in- dicated and not feel that every mixture needs them. Acids added to milk cause the lime com- bined with the casein to combine with the acid and afterwards the casein Zenegra 50 combines with acid and forms sour milk curds. This is what takes place in the production of buttermilk. When butter- milk comes in contact with rennet ferment of the stomach it will not Zenegra Uk form a curd like sweet milk, so its use can be understood better when this fact is kept in mind. When gruel diluents are added to milk, the gelatinized starch of the plain gruels, or the llocculent proteid of digested or dextrinized gruels, is dispersed through the milk and when the rennet has acted on the casein, it is found that the casein curd is very finely divided by the cereal addition and rendered softer and more digestible, so this is a purely mechanical method of modifying the casein. Under the older teaching about all that the student had in mind was the making up of a food mixture on about the following basis: — re- arrange the quantitative composition of cow's milk and add a fixed amount of alkali Zenegra 100 to every mixture, no matter how much or how little milk it contained. If this food did not suit, try differ- ent combinations of the food elements and alkali. lieyond this point all was uncertain and not to be recognized as scientific. In the future the subject will undoubtedly be presented on about the following lines: The in- fant needs fats, proteids, carbohydrates, mineral matter and water, but in this respect does not differ from the adult. As the infant's digestive apparatus is not fully formed it needs these food elements in peculiar forms which are adapted to a developing stomach. Milk is the natural food for this period of development. As animals grow with different degrees of rapidity, and as their digestive tracts show wide differences in form and function, milks of different species of Zenegra 100 Mg animals are not interchangeable either from a quantita- tive composition standpoint or in their digestive properties. Rearranging the percentage composi- tion of cow's milk does not give it the prop- erties of human milk. To make it acceptable to the infant the casein must be also modified. Just how this should be done is a matter for the physi- cian to determine on the spot and according to the nature of the case. It may be that when the stools are very curdy, the addition of lime water, sodium bicarbonate, or potassium carbonate Buy Zenegra to make the milk decidedly alkaline and thus change the casein into an alkaline compound that will not be acted upon by the rennet of the stomacli, may be indicated ; or sodium citrate may be added, or the milk may be peptonized. Under normal conditions it would seem better to me- 332 VAUGHAN: FRACTURE OF SKULL. [New Yoek Medical Jouenal. chanically alter the casein by the use of gruel diluents and allow the gastric function to be per- formed naturally. When it is found impossible to nourish the infant by the use of cow's milk modified in any of these ways, recourse may ba had to vegetable foods as Zenegra Online for instance the legume flour gruels, be- ing careful to supply sufficient quantities of fats, proteids, carbohydrates, mineral matter and water Zenegra 100mg to ensure proper development. With such an idea before the practitioner, every case treated will be an education and tend to bring out clearly the indications for the dif- ferent methods of feeding and not foster the be- lief alread)' too prevalent that there are no scientific principles involved in infant feeding. In home modification of cow's milk there is one point that cannot Cheap Zenegra be brought out too strongly and that is the fallacy of attempting to work on

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