se of a
considerable interval from the time of its being taken, which warrants
this conclusion. The coagulation of the curd is the first change which
the milk of any animal undergoes when introduced into the stomach. The
coagulum of human milk is soft and flocculent, and not so thoroughly
separated from the other elements of the fluid, as the firm hard
coagulum or curd of cow's milk becomes from the whey in which it floats.
In a state of health the abundantly secreted gastric juice speedily
redissolves the chief part of the curd in the stomach, while when it has
passed into the intestine the alkaline bile which there becomes mixed
with it, completes its solution, and converts the whole into a fluid
which closely resembles one of the chief elements of the blood, is
consequently very easily taken up by the minute vessels whose office it
is to do so, and thus supplies with nourishment the whole body.

Milk tends, however, to undergo changes spontaneously, which produce
its coagulation, and the occurrence of these changes is greatly favoured
by a moderately high temperature, such as that which exists in the
stomach. But the alterations of the fluid that accompany this
spontaneous coagulation are very different from those which are brought
about by the vital processes of digestion. An acid becomes formed within
it, and the acid thus produced has none of the solvent power of gastric
juice, but by its presence impedes rather than favours digestion. Every
nurse is aware that a very slight acidity of the milk will suffice to
give an infant vomiting, stomach ache, and diarrh[oe]a, and the result
must be much the same whether fermentation had begun in the milk before
it was swallowed, or whether it commences afterwards, in consequence of
the disordered condition of the stomach, and the absence of a healthy
secretion of gastric juice.

The nature of the food is the first point that requires attention in the
management of these cases of infantile dyspepsia. If the child had been
fed on cow's milk the symptoms may be due to the gastric juice not
having been able to dissolve the curd, which you will remember is much
firmer than that of human milk as well as twice as abundant. In this
case the substitution of asses' milk, the employing whey either entirely
or in part instead of milk, and the adding white of egg in order to
present the elements of the curd in a more easily digestible form, may
all be tried with advantage. Sometimes chi