Observations upon the so-called food intoxication of infants with especial reference to the alveolar air

There is a condition which has been described under the heading of “Food Intoxication” and “Toxicose” in infants, which is a very fatal one. It is found in the course of severe diarrhoeas and as the terminal stage of various disturbances of nutrition. It is characterized by several striking symptoms, chief among which are dyspnea and excitement, changing into stupor and eventually coma. In its early stages, the condition is difficult to recognize. When it is marked it is unmistakable.

The observations which we have to report were made with the desire of learning more with regard to the essential causes of the condition and of developing some method by which it could be recognized in its incipiency when successful therapy is possible.

It was suggested many years ago by Czerny that acids might have some part to play in it for the reason that the dyspnea resembles that seen in rabbits when given mineral acids and the condition has been often spoken of as acidosis, meaning thereby an increase in the acetone substances. These, however, have not been found to be in excess.

For the last two years we have examined the blood of children suffering from this condition according to the method described by Sellards which consists in evaporating to dryness, with phenolphthalein, the blood serum from which the proteins have been removed by absolute alcohol. A colorless residue indicates an almost complete absence of carbonates from the blood. Marked cases of intoxication show the carbonates to be very greatly reduced in every single instance. In mild cases this is not found to be the case.

Sellards'other method of determining acidosis,-that is, proving a great tolerance to alkali before the urine becomes alkaline, is also striking with these children.