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April 1929


Author Affiliations

From the Otolaryngological Department of the Children's Hospital

Arch Surg. 1929;18(4):1774-1782. doi:10.1001/archsurg.1929.01140130874057

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Among the many factors contributing to the present infant mortality, there persists today a symptom-complex, the death rate from which is appallingly high. I refer to the clinical entity known here in Boston as acute nutritional disturbance. It presents the picture of a previously well and happy infant who, often within the space of a week, is precipitated into a most prostrating illness, characterized by fever, diarrhea, vomiting, dehydration and loss of weight. The condition is analogous to the older disorders known as "summer diarrhea," "summer complaint," "cholera infantum" and acute enteritis.

Etiologically, there are three basic disorders responsible for the production of the same clinical group of symptoms: (1) improper feeding, (2) a true enteric infection restricted to the gastro-intestinal tract and (3) a para-enteral infection characterized by a focus outside the gastro-intestinal tract. It is therefore obviously essential to determine which of these three conditions is present before

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