the determining causes of apoplexy, I think we shall find an exact indication in that disease for the use of milk. Neither can I say that constitutional debility was common to all patients whom I placed under the milk cure; on the contrary, I have made persons of florid complexion undergo the treatment --persons of a muscular build and a full pulse— who are generally ordered a temperate regimen and who, to prevent congestion and apoplexy, take bitter and saline solutions with benefit.' Dr. Karell concludes by strongly expressing himself against the practice of extolling the milk cure as a panacea.

During the last four years I have put the milk treatment to the test of direct experiment, both in hospital and private practice, in a variety of chronic maladies, especially in the chronic nephritic form of Bright's Disease and Diabetes mellitus. I have already laid a portion of my experience in these diseases before the profession in a series of papers contributed to the Lancet." I may justly claim to have been the first to apply the remedy systematically and successfully to the treatment of Diabetes. I can find no mention of anyone else having previously attempted to treat this formidable malady exclusively with milk.

1

1 Oct. 16 and 23, Nov. 27 and Dec. 4, 1869, April 23 and 30, 1870, and May 6, 1871, &c.

17

CHAPTER II.

MILK : ITS PHYSICAL CHARACTERS, CHEMICAL COMPOSITION, AND PHYSIOLOGICAL RELATIONS.

Ir is not within the scope of the present work to give a complete account of the chemistry and general physiology of milk-human or comparative -or of the organs and processes by which it is formed. It is the intention of the author rather to consider its physical and chemical properties, simply as an alimentary substance; its relation as such to the blood and tissues; the changes it undergoes by the process of digestion; and, lastly, its therapeutic action as a remedy in disease, together with the method of its administration as such.

Milk is a fluid secretion formed from and closely resembling blood, for the exclusive purpose of being again converted into blood. Its only function is to constitute the food of the young of all mammalia immediately after the period of their birth, and

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until they shall have attained such a degree of maturity as to render them capable of maintaining an existence independent of the maternal parent, by subsisting on the particular kinds of crude aliment for which each species is fitted by organisation and habits. And it is a remarkable and, I may add, a highly instructive fact, that however varied the size, conformation, habits, and food of adult mammals may be, yet nature has prepared for them in their earliest infancy this one universal food, whether they are cetaceans, like the whale, inhabiting the deeps of polar seas, or the herbivorous or carnivorous denizens of tropical forests and plains. The contemplation of this fact alone leads to the inference, based on a knowledge of the perfect adaptations of an unerring design displayed in the economy of nature, that milk must possess, not only all the ingredients of a perfect food, but also that as such it must be endowed with special qualities which confer on it the power of regulating and insuring a healthy nutrition and growth of the tissues at a period of animal life when these processes are most active, and thus prevent the occurrence of abnormal deviations ending in abnormal and extraneous formations, or, in other words, disease.

Milk is a white, opaque, thickish fluid; when a

drop of it is examined under the microscope it is observed to be a somewhat turbid fluid, in which are suspended a large number of irregularly-shaped particles, varying in size from about the 1 12.700 to the 1 3.040 of an inch. These are commonly called milk globules; they consist of an albuminoid envelope enclosing the oleaginous matter of the milk, or butter. In addition to these globules, numerous molecular granules, very much smaller in size, are observed in the milk; they exhibit the peculiar movement witnessed in molecules generally, and appear to consist simply of oily matter, and are readily dissolved by the action of ether. The large milk globules, however, are not soluble in this reagent alone, a fact clearly demonstrating that they are not composed simply of fatty matter. Hence, when milk is mixed with ether it still retains its whiteness and opacity, no transparency being produced; but if it is mixed with a sufficient quantity of caustic potash, or acetic acid, the envelopes of the milk globules are dissolved, and the contained oily matter, or butter, is set free, and is then readily capable of solution by the application of ether. This fact shows that the envelopes containing the butter are composed of albumen. When, after the

application of potash, the liberated butter has been dissolved by the addition of ether, the whiteness and opacity of the milk are removed and a clear fluid is produced.

All the ingredients of milk, except the butter globules and granules suspended in it, are in a state of solution. The butter globules and the greater portion of the granules arise to the surface after milk has stood a certain length of time, forming a thick stratum of cream on the surface. The cream, then, consists of the butter globules having a coating of albumen, and of oleaginous molecules. In the process of churning the albuminoid coats of the globules are ruptured by the violent agitation to which they are subjected; the particles of fatty matter escape, and butter is formed by their aggregation and coalescence.

The object attained by the oleaginous matter, or butter, being enclosed in albuminoid envelopes in the form of milk globules, is, undoubtedly, to insure the perfect mechanical admixture of all the ingredients of milk, so that a single drop may contain the whole of them. Were it not for this exceedingly admirable contrivance the butter would form an oleaginous stratum, which, floating on the surface, would render the proper feeding of the infant