Hydrolysed casein for parenteral administration to infants.

Since the year 1939, when preparations of protein digests became generally available in America, reports of investigations designed to test their value in the parenteral feeding of infants have appeared from time to time. ' Amigen,' an enzymic digest of hydrolysed casein, is one of these preparations. Shohl, Butler, Blackfan, and McIlan (1939), using ' amigen ' as the sole source of nitrogen in the diets of normal infants, found that it was as well utilized as the nitrogen supplied by an evaporated milk mixture so composed as to supply a similar quantity of food with the same percentage composition. Moreover, it was found that if the 'amigen' (again as the sole source of nitrogen) were given intravenously for periods of twenty-four hours, the subjects were still kept in a positive nitrogen balance comparable in magitude with the balance obtained when the ' amigen ' was given by mouth. Shohl (1943) also was able to show that infants suffering from gastro-enteritis were maintained in positive nitrogen balance when ' amigen ' was given intravenously in quantities sufficient to provide the protein equivalent of atleast2 2g. perkg. per day, whereas similar infants who rceived only glucose solutions intravenously showed a negative nitrogen balance. Jonxis (1946) obtained good positive nitrogen balances by using solutions of ' capaine ' (a digest of casein and lactalbumin prepared in Rotterdam) to supply a protein equivalent of about 2 g. protein per kg. per day. His subjects were suffering from only moderate degrees of food intolerance. Some reactions following the administration of 'amigen' have been reported, but later observers (Dodd and Rapoport, 1946) were able to give it for long periods to infants without the occurrence of reactions. They found, however, that thrombo-phlebitis at the site of the injection was often troublesome. The present report* concerns a trial of a British enzymic digest of casein, 'casydrol', allocated by the Medical Research Council to the Children's