Since the establishment of pediatrics as an independent branch of medicine, there has been a great deal of discussion as to the pathogenesis of the chronicnutritional disturbances of infancy. The discussion has, for the greater part, taken place in the German literature. Many types of disturbance, among them those which we now know to be due to such chronic infections as tuberculosis and syphilis, have been included by some authors in the discussion.
This paper deals with that chronic condition of extreme malnutrition of infants which occurs independently of known infection and is not accompanied by acute gastro-intestinal or nervous symptoms. Without entering into any extensive discussion of the symptomatology or nomenclature, suffice it to say that the condition is, in a general way, the one which has been described by the terms "infantile atrophy," "marasmus" or "alimentary decomposition." On account of the fact that some of these terms, particularly