This section is from the book "Practical Dietetics With Special Reference To Diet In Disease", by William Gilman Thompson. Also available from Amazon: Practical Dietetics with Special Reference to Diet in Disease.
The frequent occurrence of constipation is a not unfavourable indication that the milk is being well digested and very completely absorbed, leaving but small residue. Diarrhoea or obstinate vomiting, on the other hand, indicate indigestion and malnutrition, and the difficulty should be corrected by temporarily reducing the quantity of milk and prolonging the intervals between the doses to four or even six hours. The constipation is met by the #use of a pill of two grains of inspissated oxgall, or by the compound licorice powder (pulvis glycyr-rhizse compositus), or a dose of rhubarb, or half an ounce of castor oil, or thirty to sixty minims of fluid extract of cascara. The addition of coffee to the milk drunk in the earlier hours of the day sometimes renders it more laxative, and, if necessary, prunes or stewed or baked apples may be taken once daily, in the middle of the afternoon.
In addition to the milk, patients should be allowed a reasonable quantity of water or of aerated waters. It is well that some water should be given even though thirst be not complained of. After a fortnight or three weeks some patients complain very much of the absence of solid food, and in such cases - if the digestion is favourable - stale bread, crackers, dry toast, or a little salted Dutch herring may be allowed, or a milk soup thickened with barley or groats. Some patients do well to take one of the prepared starchy foods, such as are in familiar use for infant feeding. As a usual result of the treatment, patients lose weight somewhat during the first ten days or two weeks, but after the quantity of milk begins to be increased they may gain considerable flesh and strength, excepting in the case of very obese persons, who may continue to lose fat after the maximum dosage of milk has been attained. Drowsiness is also a common symptom in the first few days. The urine is increased, and is pale in colour and of low specific gravity. The tongue is covered with a thick white or yellowish coating, and there is usually a disagreeable, mawkish taste in the mouth.
The latter condition may be relieved very largely by proper care (compare Treatment of Typhoid Fever, p. 432). The increased quantity of urine is possibly due to the large amount of lactose, which is somewhat diuretic in action; but when given alone I have not found it to possess exceptional power in this direction. According to Weir Mitchell, the uric acid is greatly reduced in the urine and the colour is of a somewhat greenish hue, and indol and skatol also disappear. Weir Mitchell calls attention to the extensive changes in assimilation in the body which these various alterations in excretions indicate.
After about six weeks of this milk diet the substitution of solid food is to be gradually made, reducing the number of milk meals by at first one a day for a day or two, then by two, and so on until all food is taken solid, and Karell suggests that lean, raw scraped beef with stale bread is the best to begin with. The diet should be so graded as to consist largely of milk for several months.