A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Science
A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Medicine -- Practice
As to the method of administration, my practice with adults is to give
eight ounces (an ordinary tumblerful) every two hours, beginning at
seven or eight o'clock in the morning, and continuing to the same hour
in the evening. Sometimes it is well to begin with half as much at
first, but rapidly to increase to the required amount. This method
ensures the ingestion of three to four quarts daily--a quantity
generally sufficient to maintain the body-weight of an adult person of
average size and taking moderate exercise, although a slight reduction
may take place at first. But if the individual is very active or of
large size, it will not be found sufficient. In such event the quantity
must be increased as demanded by a feeling of unsatisfied hunger. I
have known fourteen pints to be taken in twenty-four hours. But when
the quantity becomes thus large, the inconvenience in ingesting it is
very great, and it is much more convenient to coagulate the casein of a
part of the milk and use the curd thus obtained, while the second part
is drunk. Curd may be seasoned with salt to make it more palatable, and
should be thoroughly masticated before it is swallowed.
The milk should not be taken too cold, especially if the amount
ingested is large, else it is likely to reduce the temperature of the
stomach below the point necessary for gastric digestion. The
temperature should not be less than 60° F., nor much over 100°.
Something depends upon the idiosyncrasies of the patient, which must be
the guide as to temperatures intermediate between those named.
The chief advantage of the skim-milk over the unskimmed is simply that
it is more easy of digestion. Many persons who cannot take unskimmed
milk for any length of time without its deranging the digestion, or, as
is commonly said, making them bilious, can take with impunity milk from
which the cream is removed. Although Salomon[48] claims to have shown
that glycogen is produced in the liver of rabbits fed upon pure olive
oil, it is at least probable that fat is among the last of the
substances undergoing this conversion, and in ordinary cases of
diabetes it is rather its indigestible nature which renders it prudent
to remove from milk the greater proportion of fat by skimming it off.
[Footnote 48: _Virchow's Archiv_, Bd. 61, Heft 3, 1874, 18.]
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