An exclusive diet of milk as a cure for certain chronic diseases is advocated by some physicians, and in whose hands it has met with considerable success. Karell, of St. Petersburg, and Weir Mitchell are to be mentioned among those who have extensively used this form of treatment. The treatment as a "cure " does not apply to the temporary exclusive milk diet of typhoid fever and similar acute febrile conditions, but it is believed by the advocates of the milk diet that this form of food not only counteracts certain abnormal conditions and meets definite requirements of the body, but that the milk diet itself possesses a special curative value in some cases. Bauer says emphatically: "It is an indisputable fact that in certain diseases a methodical use of the milk cure gives results such as can be attained by no other treatment".

It is recommended in obstinate cases of chronic intestinal disorders, especially neuralgia, intestinal dyspepsia, and colitis; in chronic congestion, hypertrophy, and fatty degeneration of the liver; in asthma, pulmonary catarrh, and emphysema; in dropsies of renal, cardiac, and hepatic origin; in hysteria and hypochondriasis, in which the predominant symptoms are dyspepsia and malnutrition; and in chronic catarrhal conditions of the whole alimentary canal.

The milk cure is also recommended in cases of neurasthenia, obesity, rheumatism, gout, chronic valvular cardiac diseases, chronic Bright's disease, and endarteritis.

Dosage And Method Of Giving The Milk

The milk used is skimmed, and it is important to have it obtained as fresh from the country as possible. It is customary to begin with comparatively small doses - about four ounces, once in two hours throughout the day, with one or two doses at night. Karell gives the milk lukewarm. At the end of a few days the dosage may be increased to six or eight ounces, and the intervals made three-hourly, and finally four-hourly, when twelve tumblerfuls are given daily. Pecholier gave three litres per diem, in two-hourly doses. When the treatment is undertaken it must be carried out with absolute regularity and system, both as regards the quantity of milk consumed and the intervals at which it is given; otherwise, if too large an amount is drunk at one time, or the intervals are too frequent, undigested milk remains in the stomach to mingle with the fresh doses, and abnormal fermentation and dyspeptic symptoms result. It is much better that the milk should be given alone whenever large quantities are to be taken for a long time. If diarrhoea exists, the milk may be boiled or taken hot at any time, if the patient so prefers it, but this is not necessary.

If the passages from the bowels are normal in appearance - small and solid - the milk is being well digested and absorbed, and the quantity may be increased. Usually the greatest difficulty with indigestion in this form of treatment occurs during the first week; afterward, as a rule, the alimentary canal becomes accustomed to the diet and digestion proceeds actively and nutrition improves.

Many patients - either from imagination or from past experience with milk drinking - insist that they are unable to take it in any form, but it is rare, indeed, to find any one who cannot digest milk if it is made palatable and properly prepared. For this purpose, suggestions will be found under the heading of the article on the Adaptation of Milk for the Sick (p. 74), to which the reader is referred. Not a few learn to prefer the milk to more highly seasoned food. If the patient chooses - and it is wholly a matter of taste - the milk can be flavoured with very weak tea, weak coffee, or caramel, and a pinch of salt should be added in most cases to each tumblerful. Exceptionally the flavour of a little spice of some sort may be preferred. Some patients do better if the milk is diluted by one third or one half with some alkaline table water, lime water, or Vichy, or it may be scalded with a little boiled water to which five grains of sodium bicarbonate and three or four grains of common salt are added. Milk from first-class thoroughbred cows, such as Alderneys, is often too rich, and it is undesirable to give any milk in this cure which contains much cream.

Skimming the milk is therefore necessary in most instances, and in some cases, even after the milk is skimmed, it is better digested if considerably diluted.

In carrying out this treatment much depends upon previously gaining the confidence of the patient and having him thoroughly understand the theory of the cure, so that his willing co-operation may be obtained in a method which is monotonous and wearisome at best. By a little tact and persuasion with care in framing the original rules and supervision over their execution the cure may often be conducted with great benefit in seemingly difficult cases. The one object of the treatment is to enable the digestive organs to rest and recuperate when they are in an exhausted or irritable condition by giving only small quantities of the simplest form of food at first. Later, as digestion improves, larger amounts will be tolerated and the strength and nutrition of the patient will be promoted by increasing the dosage of milk to whatever maximum can be reached without taxing the stomach.