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To the Editor: The report of a case of kwashiorkor in New York City (Amer J Dis Child112: 76-78, 1966) reminds me that such cases were not rare in civilized countries just 50 years ago. When I studied pediatrics in Breslau, Germany, in 1922, the professor used to talk a lot about a disease called "Mehlnährschaden," the symptoms of which are the same as those of kwashiorkor; the babies whom I later saw myself with this disease looked more or less like the Puerto Rican baby pictured in the Journal. It occurred when diarrhea in the infant was being treated with "mehlsuppe" (a concoction of flour in water with some sugar) instead of milk. The diarrhea disappeared and the baby continued to look well (at least in the eyes of the mother) so that he was brought in for treatment at a very late stage. By the time I