3. Dilution With Water

The dilution of milk is accomplished by adding plain water, either hot or cold, in the proportion of one part to two or three of milk. If the milk is exceptionally rich in cream and casein this simple means will often be sufficient to ensure its better digestion, for the curds become both smaller and softer.

4. Dilution With Alkaline Or Aerated Water

Lime water may be added in the proportion of two to four or more tablespoonfuls to each tumbler of milk, taken cold. In cases with much acidity of the stomach the lime water should be mixed in the proportion of one half or even two thirds. When so given, the taste of the milk is so little altered that very few patients object to it, and some even find it more agreeable. If diarrhoea or nausea is present they are controlled to some extent, but on the other hand constipation is increased by the use of lime. When the latter exists it is better to dilute with Vichy or carbonic-acid water. If lime water is added to neutralise the acidity of cow's milk the temperature of the mixture should not be raised above that of Pasteurisation - 1600 to 1700 F. - because the albuminoids are more or less decomposed in a boiling alkaline solution. It is better to separately sterilise the lime water and add it afterwards.

Barley water may be used as a diluent for milk in diarrhoea, but oatmeal water is better for constipation.

Aerated waters, such as carbonic-acid water, alkaline Vichy, bottled plain soda, or Apollinaris, may all be added to milk, in any desired proportion. In cases of fever four ounces of a mixture made with equal parts of the diluent may be given every hour, or eight ounces every two hours, up to two and a half or three pints of milk per diem.

Most of these waters are best used with cold milk, but for many persons hot milk and Vichy make a very agreeable combination, which is often soothing to the obstinate cough of bronchitis. The gaseous waters relieve the "flatness " of the milk, and prevent the after-taste of it in the mouth, of which many patients complain. The mixtures with Vichy and lime water are especially serviceable where extreme irritability of the stomach is present with a tendency to the immediate rejection of all fluids.

5. Dilution With Amylaceous Foods

Any form of starchy food - flour, arrowroot, etc. - serves as a mechanical diluent of milk by mingling with it and preventing the precipitation of tough curds. Bread and milk, or crackers and milk, serve the same purpose, and, being semisolid, have the further advantage that they must be eaten slowly and mixed with saliva.

When infants vomit their milk it may be temporarily attenuated with either barley water or oatmeal water added instead of plain water, and in the same proportion - i. e., one third or one half. The much-extolled starchy "infant foods" are less useful as foods than they are as diluents of milk, and if used temporarily with the latter object solely in view, they are less liable to produce rickets, scurvy, gastric catarrh, and other maladies. Whenever amylaceous substances are selected to dilute milk for infants they should first be as far as possible converted into dextrin and glucose, for gummy dextrin, saccharine, or even gelatinous materials are all better than crude starchy foods.

For adults a tablespoonful of Mellin's or Nestle's food dissolved in an ounce of hot water and added to a glass of milk is both palatable and nutritious in cases of phthisis or scrofula.