Clinical results point to barley water as the best diluent, as it produces the finest curd. As a result of Dr. Chapin's study and experiments made by Dr. Arnold Eiloart, a receipt has been devised by which a mixture of barley or wheat flour is treated with maltine, the effect of malt upon milk being to favor its digestion and assimilation. Dr. Judson C. Smith, who is a district visitor for the hospital mentioned, says he has used the extract of malt to peptonize milk for about a year, both for infants and adults, with very satisfactory results. His method has the advantage of simplicity. One tablespoonful of malt is added to a pint of milk, which is heated from twenty to thirty minutes and then brought to the boiling point, which practically Pasteurizes the milk. It is to be diluted for administration according to the age of the infant. Top milk should be used with the proportion of cream sufficient to give at least four per cent after dilution; thus, twelve per cent of cream would be required to allow for two parts of water to one of milk, which is the dilution advised by Dr. L. Emmett Holt in order to reduce the proteids to their normal proportion. By careful experiment he has found that one quart of ordinary cow's milk, allowed to stand for six hours in a common fruit or milk jar, will give about five ounces of top milk of this strength.
The underlying truth of all the past and present agitation concerning the purity of the milk supply and the artificial feeding of infants is that both have been sadly neglected for many years, with the pitiful result of a vast amount of suffering and many useless deaths of children from one to five years of age, especially during the hot summer months, when it is so difficult not only to secure but also to protect the milk upon which these little ones depend. Comparatively few people stop to consider how quickly dangerous changes take place in this important article of food and how readily it becomes contaminated by absorption of various volatile substances. This is particularly true of those who have the immediate charge of milk. It is appalling to any one understanding the subject and its bearings to see the carelessness that is frequently displayed by the milkmen, maids, and nurses, all of whom play so important a part in infant dietetics. Is it any wonder that philanthropists, scientists, and physicians have combined in solicitous effort to wake up mothers to the crying need for a pure supply of milk and for its proper administration to save helpless and suffering infants? The subject is of infinite importance, and should be kept constantly to the front. The truths concerning it should be iterated and reiterated until satisfactory evidence has been given that persistence in a cause like this has been of some avail in changing existing conditions that are a reproach to our people and a menace to our health as a nation.
