Nutritional Keratomalacia in Infants

Keratomalacia, which has been defined by de Schweinitz as infantile ulceration of the cornea with xerosis of the conjunctiva, is synonymous with xerophthalmia, but as the most characteristic changes take place in the cornea, keratomalacia is possibly the term of choice.The four cases herewith recorded are published on account of the light which has recently been thrown on the etiology of a disease comparatively rare in this country.The first two cases were taken from the records of the Children's Department of the Johns Hopkins Hospital, and the last two cases were observed by me in the same clinic during the past year.They are the only cases which have occurred in more than 28,000 admissions to the clinic.REPORT OF CASES Case 1.=m-.W. G., female, white, aged 3=1/2, was admitted June 29, 1917.Diagnosis.=m--intestinal indigestion; keratomalacia; sclerema.History.=m-.Full term, normal delivery.Weighed 12 (?) pounds at birth.Had "snuffles" at age of 3 weeks.Was breast fed for three weeks.Weaned at that age and fed on condensed milk.Apparently healthy until two weeks ago, when mother noticed child was becoming thin.However, she took her feedings well.June 18, vomiting and severe diarrhea commenced.Since then the child has been fed on barley water and occasion¬ ally egg-albumin water.The vomiting ceased after three or four days, but the diarrhea has continued, with the passage of greenish, slimy stools which con¬ tained no blood.She has suffered from a hacking cough throughout the illness, and for the past week has been somewhat stuporous and feverish.Three days before coming to the clinic both corneae were noticed to be dull in appearance.