MILK DIET AS A REMEDY For Ch ronic D isease BY CHARLES SANFORD PORTER, M. D. ELEVENTH EDITION LONG BEACH, CALIFORNIA 19 2 3Copyright, 1905, 1908, 1911, 1913, 1915, 1916, 1918, 1921 and 1923 by Charles Sanford Porter, M. D.Preface to Third Edition Since the first publication of thisd work in 1905, two large editions have been disposed of, and another is required. This is especially gratifying, in view of the fact that the sale of the book has not been urged, except a» one purchaser or patient would recommend it to another. The succeeding editions have not differed materially, in describing the method of treatment, except in the effort to make the directions more explicit and to provide for certain contingencies. The fact that I have a large correspondence with people who contemplate taking, or have, or are taking a milk diet in some way has afforded me very valuable information as to their needs, and enabled me to emphasize, or make clearer, features which may not have been sufficiently plain for everyone in the earlier editions. Valuable contributions regarding the treatment are frequently offered me, and, after a thorough test, may be incorporated in the book. Unless otherwise credited, all the statements made regarding reactions, results and the method of operation of the treatment are from my own observation. Orders for the book have come from every part of the United States, from Canada, England and other foreign countries; translations in whole or in part have also been made into other languages. I hope the new book will meet with the same favorable unanimity that its predecessors received. C. S. P. Burnett, California, January 31, 1911. Preface to Fourth Edition In preparing this edition, a few changes have been made in the text, a chapter added on High Blood Pressure (hard arteries), and more information given about diet after taking the treatment. I wish particularly to call the attention of physicians to the great benefit and permanent cure of hard arteries and high blood pressure by means of this treatment. C. S. P. Burnett, California, October 1, 1913. Preface to Fifth Edition In a little more than a year another edition is required, and I take advantage of this fact to revise the book throughout. Additions have been made to many subjects. The history of the milk cure has been presented more extensively and credit given to early investigators.A chapter has been added on the subject of auto-intoxication, and the use of sour milks, and the lactic acid bacilli. Much new information will be found on the treatment of constipation occurring on a milk diet, and also some new facts concerning diabetes. C. S. P. Burnett, California, January 1, 1915. Preface to Sixth-Seventh Edition In these editions I have added new matter throughout wherever required to make the book what I want it to be—a practical working treatise on the subject. I can report continued and almost unvarying success in the cure of such diseases as Anemia, Dyspepsia, Dysentery, Ulcer of the Stomach, Hard Arteries with High Blood Pressure, and Nervous Disorders of the Heart. The chapter on After Treatment, as revised and enlarged, will be valuable to all, whether they have taken the cure as I recommend or not. I hope every patient will study the book, not simply read it. C. S. P. Burnett, California, March 31, 1918. Preface to Tenth Edition Cures by diet, and especially by the Milk Diet, are now being accomplished throughout the world. At last the importance of dietetics in healing is generally recognized. In my opinion, it excels any other method in curing chronic disease. This edition has been largely rewritten, and numerous additions made. At least 18,000 patients have taken the treatment under my direction in the last 37 years. C. S. P. Burnett, California, August 25, 1921. Preface to Eleventh Edition Diabetes can now definitely be added to the list of diseases cured by the milk diet. C. S. P. Burnett, California. March 10, 1928.TABLE OF CONTENTS Page PREFACE ..................................... 5 TABLE OF CONTENTS.............................. 7 SYNOPSIS .................................... 14 INTRODUCTION ................................. 15 Erroneous Modern Diets—Devitalized Foods—New Dietetic Discoveries—Vitamines—History of Milk Cure—Used by Ancients, Russian, Swedish, German, English and American Physicians— Skimmed and Unskimmed Milk—Direct Absorption into Blood— Secretion and Composition of Milk—Living Cells—Wrong Methods of Using Milk—Milk Cure Simple but Must Be Done Right—Kind of Milk Important—Thousands of Cases Treated in 37 Years— Directions Must Be Carefully Studied. CHAPTER I. PRELIMINARY ARRANGEMENTS............... 25 Complete Instructions—Arrange All Details Before Starting— The Room—The Bed and Bedding—Furniture—Large Supply of Air Required—New Way to Ventilate Rooms—Sleeping Garments —Toilet Necessities—Graduated Milk Glass—Striking Clock— Visitors—Water Heaters—Bath Tub—Cannot Take Cold on Milk Diet—How to Handle Milk—Holstein Versus Jersey Milk— Cream and Mineral Contents—Fresh or Old Milk. CHAPTER II. REST....................................... 36 Reasons Why Necessary—Relaxation Essential to Cure— Growth While Resting—Reason for Warm Bath—Vital Organs8 MILK DIET Page Get First Benefit—Other Parts Improve Afterward—Energy-Stored Up While Resting—Improvement of Generative Organs and Nerves—Of Dilated or Prolapsed Stomach and Intestines—Of Kidneys—Of Heart and Blood Vessels—Quick Relief of Dropsy —Of Apoplexy . CHAPTER III. PSYCHOLOGY OF THE MILK CURE............... 45 No Suggestion or Faith Cure About This Treatment—Elaborate Apparatus or Frequent Examinations Unnecessary—Difference Between Sanitarium and Home Treatment—Discomfort or Pain While on Milk Diet—No Danger in Crowding Milk While Resting—Do Not Make Changes in My Tested Method. CHAPTER IV. STARTING THE TREATMENT..................... 50 Importance of Details—Success Depends on Faithful Following of Directions—Fasting—Fruits Allowed—Who May Omit Fast— Who Must Take It—Injury from Too Long Fast—Weighing— Measurements—Amount of Milk to Be Taken—Danger of Too Little Milk—Of Too Much—Starting Amount—Interval Between Drinks—Method of Drinking—Foods Allowed with Milk—Sleep— Digestion of Milk—Indigestible Curds—How to Warm Milk— Night Drinking—Milk for Weak Stomach—Skimmed, Separated, Diluted Milk—Disagreeable Symptoms—Preparation of Bath— Temperature Very Important—Ventilation of Bathroom—Wetting of Hair—Bathing During Menstruation—Time Required for Cure —Length of Time Milk Can Be Used—Effective Work While on Milk Diet—Ella Wheeler Wilcox’s Endorsement—Milk Diet While Working—Disorders Cured in Four Weeks’ Course—Crises During Treatment. CHAPTER V. REACTIONS DURING TREATMENT.................. 72 Changes in Circulation of Blood—Quick Return of Pulse Rate and Blood Pressure to Normal—Record of 32 Abnormal PressureCONTENTS 9 Page Cases—No Strain on Heart—Effect on Heart, Lungs, Kidneys, Muscles, Skin, Hair, Stools and Urine—Stimulation of Milk Diet —Rapid Improvement of Diseased Stomach and Bowels—Growth of Muscles—Frequency of Urination—Hyperemia or Congestion of Blood—Pulse Rate—Effect on Fever, Diabetes, Goiter, Catarrh— Gain or Loss in Weight—Controlling Diarrhea on Milk Diet— Sweating—Cold Feet—How to Change from Milk Diet to Ordinary Food. CHAPTER VI. DYSPEPSIA .................................. 95 Easily Cured by This Method—Varying Effect of Diet on Different Patients—Dislike of Milk Unimportant—Removing Odor from Milk—Hunger—Thirst—Craving for Sour Foods, Lemons, Tomatoes, Apples—Sweet Fruits Allowed—Amount of Sleep— Curing Insomnia—Defective Breathing—Oxygen a Food—Making It Too Easy for Stomach—Worthless Manufactured Cereal Foods —Causes for Dyspepsia and Starch Indigestion—Meat or Protein Diet, Without Starches, Best for Some People—Acid Fruits. CHAPTER VII. CONSTIPATION ............................. 105 Common Trouble—Due to Ignorance or Neglect—Study of Parts Involved—Peristalsis—Hemorrhoids — Laxative Foods — Unnecessary Worry Over Constipation—Simple Cure While on Ordinary Foods—Use of Enemas—Massage—Proper Exercises—Effect of Milk Diet on Constipation—Preventing Constipation on Milk Diet —Fruit Fast—Buttermilk—Cottage Cheese — Medicines — Oils — Seaweed—Dilators—Cold Water Enemas—Color of Stools—Percentage and Permanency of Cures—Special Remedies for Obstinate Cases or Those with Piles or Adhesions. CHAPTER VIII. CONSUMPTION ............................. 122 Gain in Weight—Improvement in Blood—Changes in Lungs— Coughing Crises—How Cavities May Decrease—Importance of Air10 MILK DIET Page —High Altitude and Low—Climate—Danger of Crowded Places —Danger of Hemorrhage—Begin Milk Gradually. CHAPTER IX. CATARRH AND ASTHMA...................... 121 Varieties—Catarrh and Hay Fever Curable—Certain Cases of Chronic Asthma Helped but Not Cured—Effect of Ocean Air. CHAPTER X. AUTO-INTOXICATION........................ 130 More Common Every Year—Cause—Symptoms—Large Portion of Digestive Tract Becomes Poison Factory—Disease Only Affects Man—Catharsis—Milk Diet Has Cured Hundreds—Sour Milk as a Remedy—Metchnikoff’s Discovery—Bulgarian Bacilli— Useful Books on Subject—Various Lactic Acid Products—Medical Opposition to Simple Remedy. CHAPTER XI. RHEUMATISM ............................. 137 Easily and Permanently Cured—Why Treatment Not Used More—Crises—Elimination of Rheumatic Poison Slow but Sure, and Impossible to Make More on Milk Diet—Common Cause for Rheumatism, Gout, Bright’s Disease, Bronchitis, Asthma, Etc.— Stiff Joints — Arthritis Deformans — One Form of Incurable Arthritis. CHAPTER XII. VARIOUS DISEASES....................... 143 Not Practical to Use This Treatment in Acute Diseases— Mental Disorders—Dislike of Milk Immaterial to Treatment— Dilated Stomach—Chronic Diarrhea—Sprue—Kidney Disease— Floating Kidney—Heart Disease—Anemia—Dropsy—Bladder Disease—Stone in Bladder—Fibroid Tumors—Painful Menstruation— Improvement to Generative Organs—Diabetes—Skin Disease— Cancer—Pellagra Cured—Addison’s Disease—Hodgkin’s Disease —Thyroid Gland—Locomotor Ataxia—Paralysis Agitans—Pernicious Anemia Cured.CONTENTS 11 Page CHAPTER XIII. HIGH BLOOD PRESSURE.................. 157 No Failure if Treatment Correctly Taken—Record of Cases Treated—Tobacco Harmful—Hardening of the Arteries—Cause of High Pressure—Aneurism—Embolism—Apoplexy—Paralysis— Relation to Life Insurance. CHAPTER XIV. EXERCISE ............................. 167 Absolutely Necessary After Milk Cure to Continue Benefits— Object of Exercise—Simple Exercises Taken Regularly Best— Special Exercises Without Apparatus. CHAPTER X,V. AFTER TREATMENT....................... 175 Proper Foods—Drinks—Bathing—Clothing—Keep Skin Active —Friction Baths—Reasons Why Some Lose Benefits Gained on Milk Diet—Excessive Reading Prolific Cause of Strain and Nervous Disease—Correct Glasses When Needed—Talking—Drinking Water—Meat Eating—Vegetables — Raw Foods — Machines for Preparing—Eggs—How to Take Milk in Ordinary Life Without Causing Constipation—Wheat—Nuts—Sour Milk and Buttermilk —Junket—Proper Combinations—Monodiet Cures—Grape Cure— Apple Cure—Tomato Cure—Meat Diet—Antiscorbutic Foods. HEIGHT AND WEIGHT TABLES........................... 197 INDEX ............................................. 198DISEASE CAN ONLY BE CURED BY, AND THROUGH, THE BLOOD, AND ITS CIRCULATION IN THE LIVING PARTS OF THE BODY. ANY MEANS THAT IMPROVES THE QUALITY, THE QUANTITY, AND THE MOVEMENT OF THE BLOOD, WILL ASSIST IN ELIMINATING DISEASE.THE TREATMENT described in this book makes the purest and richest blood possible, and always increases the amount and rapidity of the circulation, if too low, as in anemic conditions. In fever, exophthalmic goiter, and toxic conditions generally, with a high pulse, there is always a reduction of the pulse rate, by this method. Where the blood PRESSURE is too high, it decreases rapidly and permanently. On the other hand, if the blood pressure is low, it invariably raises slowly to near the normal.SYNOPSIS Briefly stated the milk cure consists of the following factors: First Complete rest for all the organs of the body except 1 llol those concerned in the production and circulation of the blood, and those connected with the elimination of waste and poisonous matter. Second An ample supply of the only food that will make an immediate large production of blood possible—milk. Third An unlimited quantity of pure air to oxidize and cool the blood, and carry off the expired gases. Fourth Warm water baths, to soften the skin, equalize the circulation, relax tense muscles, calm the nerves, regulate the body heat—and, last, but not least, Fifth When the body is ready for it, EXERCISE, to strengthen the muscles, expand the lungs, limber the joints, stimulate the circulation, increase the elimination, purify the blood, develop normal secretions, train the nerves and, generally, to fix and make permanent the benefits acquired while resting and building up the body.INTRODUCTION More interest is being shown in diet and food now than ever before. The subject is being investigated from many viewpoints, but that of health is the most important. More really valuable information has been obtained regarding nutrition in the last few years than in centuries before. Dread diabetes has been conquered and in the process many valuable facts have been added to our knowledge of the metabolism of the body. Since the beginning of the present century there has been a continuous increase in the manufacture and use of degerminated and devitalized foodstuffs. The modern grocery exhibits long rows of shelves filled with pretty packages, boxes and cans, containing prepared foods that have been cooked, or sterilized, and packed, months or years before. Twenty or thirty years ago the grocer’s shop sold vegetables, cereals, fruits, nuts, oils, eggs, butter and milk in the natural condition as they came from the farm or producing point. Wheat flour contained something more than white starch, cornmeal had the rich germ ground with it, oatmeal was what it purported to be, and not a steam cooked flake. Natural, unrefined sugar was in common use. Is it only a coincidence that today there is more digestive disorder than ever before ? Nowadays a person is fortunate who never suffers from indigestion, headaches, foul breath, nausea, gas,16 Milk Diet constipation, and the more serious diseases that follow these symptoms. The excessive use of ready cooked cereals, sold in pasteboard packages, pasteurized milk, imitation butter, cold storage products, candy, chemically refined sugar, and canned foods of all kinds, deprives us of the vitamines which are present in natural foodstuffs. Animal life and vitality cannot be properly maintained in the absence of these substances. Preparations made from animal glands and egg yolks, extracts of vegetables and oranges, and cultures of yeast and lactic acid bacilli are advertised and recommended bv the a-' manufacturers to restore the missing elements, but it seems wiser to return to a more natural diet rather than use the artificial outputs of chemical laboratories. Fresh milk has all the vital substances designated as vitamines, and besides is a perfect food containing every element necessary for the nutrition of the human body. Owing to these facts the milk cure is gaining a wonderful popularity. There are some who antagonize the use of milk as a remedy, perhaps from selfish interests, perhaps because they have obtained poor results from wrong ways of taking the milk. After 39 years use of the method described in this book, I am more confident than ever that it is the best cure for the conditions described as suitable for the treatment. Milk, and milk products, have been used and highly esteemed as food by all nations possessing mammalian animals since the earliest records of history. In normal times some of the older European countries consume two or three times as much milk and cheese per capita as the United States does. A good food is a good remedy, and, as disease is only a disturbance of the mechanism of nutrition, it is onlyIntroduction 17 natural that the use of milk in ill health should be almost as old as its use as a food in health. Hippocrates advised consumptives to drink large quantities of asses’ milk. Camel’s milk, and whey cures were practiced by the Arabian physicians. Homer called the Scythians Galactophagi, or feeders on milk, and Herodotus describes their methods of handling mares’ milk. In recent times the popularization of the milk cure has been largely due to the efforts of Russian and German physicians. Dr. Inozemtseff, author of a work on “The Milk Cure,” published in Moscow in 1857, treated successfully, with the help of his assistants, over a thousand cases. Dr. G. L. Carrick, physician to the British embassy at St. Petersburg, translated a work “On the Milk Cure,” by Philip Karell, M.D., and published an article on the subject in the Edinburgh Medical Journal of August, 1866. Karell claimed to have treated successfully “hundreds of cases” of all kinds of dropsies, asthma, obstinate neuralgia, diseases of liver, and conditions of faulty nutrition. In all these he considers milk “the best and surest of remedies.” Karell does not attempt to decide whether the beneficial influence of milk in certain illnesses is due merely to its nutritive qualities or to some occult medicinal virtue. He simply calls attention to the fact that milk and chyle* resemble each other very closely, insists that milk must be taken at regular intervals, under the direction of an experienced person, in doses of from two to six ounces of skimmed milk, and *Chyle is the milky fluid contained in the lacteals of the intestine after the digestion of food. It is lymph plus digested food.18 Milk Diet that the best results are only obtained when the diet is an exclusive one. F. von Niemeyer, Winternitz, Bremer, Kuhner, Cohen, Ebstein, Gomberg, Scheiber, eminent medical authorities, have all advocated the milk diet in the treatment of different chronic diseases. Professor Bauer says emphatically: “It is an indisputable fact that in certain diseases a methodical use of milk cure gives results such as can be obtained by no other treatment.” Dr. A. S. Donkin, an American physician, wrote an interesting article on “The Curative Influence of an Exclusive Milk Diet,” for the London Lancet, in 1876. In the same volume of this medical journal appears an article by a celebrated English physician, Dr. Johnson, making a plea for a greater use of the exclusive milk diet in certain diseases. He especially notes, “in numerous cases of acute Bright’s disease, the speedy disappearance of the albuminuria under the influence of rest in bed, a few warm baths, and copious libations of milk.” He also describes some remarkable cures of inflammations of the bladder by the same treatment. The only apparent difference between the milk cures of these two physicians was that Dr. Johnson recommends unskimmed or whole milk, while Donkin prefers skimmed milk. Dr. Donkin makes this interesting statement: “Constipation is a sure sign that the treatment is agreeing with the patient, whereas diarrhea is a very untoward indication and extremely more apt to be induced by unskimmed than by skimmed milk.” He claims that skimmed milk is superior in the treatment of diarrhea of typhoid fever and dysentery, and more powerful in reducing dropsy than whole milk. Donkin also claimed that diabetes could be cured by large quantities of milk, and said that some cases could take as much as fourteen pints per day.Introduction 19 Referring to Dr. Donkins opinion of diarrhea while on an exclusive milk diet, I will say here that we do not regard it as unfavorable now, as there are perfect means of control which I treat of fully in another place. Patients having a diarrhea on three or four quarts of milk are practically sure to make a cure, no matter what their ailment may be. Weir Mitchell, who had, perhaps, the greatest experience of any American physician with chronic disease, said: “It is difficult to treat any of these cases without a resort at some time more or less to the use of milk.” Professor James Tyson, in Journal of American Medical Association, June, 1884, recommends milk diet in diabetes, calculous disorders, Bright’s disease, dyspepsia, obesity and nervous prostration in women. He notes total disappearance of uric acid sediment in the urine, and also that a persistent use of milk cured stone in the bladder. He says that in gastric ulcer no food other than milk should be permitted. Dr. Tyson also declares that no treatment that has ever been suggested in obesity, is half so efficient as a limited milk diet. Dr. L. Duncan Bulkley, physician to New York Hospital and New York Skin and Cancer Hospital, believes that milk can be absorbed directly into the blood through the lacteals. He considers it absolutely necessary that the stomach should be free from other foods when taking milk as a remedy, so that there may be no acid in the gastric juice. If acid is present milk is curdled and has to undergo the regular process of digestion. Dr. Bulkley gives pure, warm milk, without the addition of any substance whatsoever. If cream has20 Milk Diet separated, it cannot safely be re-combined with the milk. His favorite plan seems to be giving milk one hour before meals when stomach is presumably alkaline, patient lying still for 15 minutes thereafter. Dr. R. H. Babcock of Chicago thinks milk thus taken may pass into duodenum and be absorbed from there. He says his results correspond with those obtained by Dr. Bulkley in regard to the efficacy of this method. From my own observations, extending over many years, I believe that the principal parts of milk can be absorbed directly into the lymphatic circulation and thence into the blood. This assimilation takes place principally from the small intestine. Milk is secreted directly from blood, and the fluid portion of milk is similar to, if not exactly the same, as blood serum, and no doubt capable of being taken into the blood without change. The finely divided fat particles in milk do not need any elaboration to become the fatty portion of the blood. The carbohydrates (sugar) and albuminoids of milk can probably be assimilated without digestion, as v. Leube’s clinic proved these parts of milk could be readily absorbed from the colon when introduced as nutrient enemata. There is a small amount of fibrin in milk similar to the fibrin of the blood. Milk also contains a number of important soluble ferments, diastase, galactase, etc. Marfan thinks the milk ferments act as stimulants and regulators of nutrition and that they are identical in function with the enzymes elaborated by the various tissues of the body. Woodhead and Mitchell have shown that milk contains opsinins in even greater quantity than blood serum.Introduction 21 All milk from healthy cows contains cells, or leucocytes, precisely like the white blood corpuscles, and, I have no doubt that these cells are taken into our blood vessels and reinforce the cells already there, or replace those exhausted by disease. An important function of the white corpuscles is to eliminate disease germs or products from the blood, and hence they have been called the “policemen” of the blood, or scavengers. They are found in quantity wherever disease or inflammation exists in the body. The normal of these cells in our blood is about 7000 per cubic millimeter. In the newborn babe they are usually much less, but increase rapidly, and have been observed to go as high as 40,000 under the influence of the first feeding of milk. If more evidence of the direct absorption of milk leucocytes into blood were required, it can be furnished by the fact that the jugular vein in kittens that have just finished nursing, is full of white blood, loaded with leucocytes. Considering the known living elements in milk, and the vital character of the remaining parts, it can readily be seen how the application of heat, or any preservative agent, will have a serious effect on its value. The use of milk in the diet for nearly all cases of chronic diseases, is advised by all the principal textbooks with which I am familiar. The mistake is made by many of them of combining other foods, even meats and eggs, with milk, and consequently they usually add the proviso “if it agrees.” Very few physicians understand the proper amounts of milk to be given, and the proper way to give it in order to assure assimilation. The method of preparing the patient for the milk diet, and his conduct while taking it, had never been published, that I am aware of, previous to the printing of the first edition of this work, in 1905.22 Milk Diet My first introduction to the possibilities of an exclusive milk diet was in 1884 while living in New York City. A friend was cured completely and permanently of a rather serious condition, by following the advice of a gentleman recently from Germany and familiar with the milk cures practiced there at that time. Other mutual friends adopted the same plan for the relief of various ills, and all with good results. Shortly afterward I took the “milk cure,” as we understood it then, for a condition bordering on nervous prostration. I not only overcame that condition, but was cured of hay fever, which had claimed me as an annual victim for seven or eight years, but has never since returned. From that time to the present, I have never ceased to advocate the milk cure, and, of the many thousands of cases of chronic disease that have taken the treatment in the manner I recommended, nearly all have been either cured or greatly helped, and very few have failed to receive benefit. Such remarkable results have, of course, resulted in extending the treatment throughout the country. Many physicians, and some sanitariums, have endeavored to use the method. I regret that many of these have made changes in the original plan, which was apparently too simple. Very many times doctors and other patients under my care have advised me to add something to the milk, or to the method of giving it, in order to make the process more mysterious, and more attractive to many people, and more lucrative to myself. They said that people who had suffered for years without relief, traveling to many health resorts, and to noted specialists, taking expensive and elaborate treatments, would not easily be induced to use a method apparently so simplyIntroduction 23 as to be within the reach of almost every person, or household, without expert advice. While admitting the force of the argument, I have always replied that there was only one way to do the milk cure, and that I would go on to the end advocating that way. For thirty-nine years I have watched the results of this way, always willing to add anything of real benefit that would not interfere with the results we were already getting, always investigating methods of treatment that seemed to have merit, or that made claims to be able to do more, or even as much as we could, but, with the exception of the preparation of the patient for the milk diet, the regulation of the amount, and the method of finishing the treatment, it remains practically the same as when first introduced to this country. It is true that my experience has shown me what kind of milk gives the best results in certain disorders and what parts of the treatment may be omitted or modified in certain cases, and I may also say that I have spent a great deal of time investigating the why and wherefore, the reason for doing certain things, and not doing others, and the cause of certain symptoms and results that occur during a course of milk diet. This book is particularly intended for patients taking the treatment—and those who are under my personal care, or corresponding with me, must be perfectly familiar with it. For this reason it is made as brief and simple as possible, but it contains all necessary instructions regarding the treatment. It must be read carefully before beginning the treatment, and again soon after commencing, unless the patient’s condition is such that24 Milk Diet reading is unadvisable, when it should be read to them, if possible. The book is not large; the size has been kept down so that almost any invalid can hold the book, and read it, without too much physical or mental effort. Notwithstanding my efforts to keep the work small and compact, each new edition becomes larger than the previous one, on account of the addition of useful information. Educated people read so much stuff not worth remembering, in the shape of newspapers, magazines and books, that they skim over useful matter in the same way, so that I fear many people will lose sight of the essential principles of the treatment as more details are added. It is necessary to give all the instruction that I can, even though some of it may benefit only one case in a thousand, because the number of patients depending on the book is constantly increasing. The book has taken a long time to prepare, because it had to be written between the almost constant calls of my daily work, and also because the contents comprise, almost entirely, my personal experience. My library on Milk is as complete as I can make it, but in the scores of books, pamphlets and periodicals on the subject, there is little to draw on that would be of practical use in this work.CHAPTER I. PRELIMINARY ARRANGEMENTS. BEFORE commencing a course of milk diet, certain preparations are necessary. These preliminaries must be arranged beforehand, because the treat ment always includes complete rest, for a time, at least. The consideration of the apartment where the patient is to remain is of first importance. It must be remembered that, no matter what the previous habits of the patient may have been in this regard, a very large supply of fresh air will be required, if not at first, within a few hours. A room may be used, and often is, but the best results, in my experience, have followed the use of outdoor bedrooms, such as pavilions, screened porches, roofs, sheds, leantos, or even a good bed with nothing over it. In most climates some protection is required from the rain, snow, sun, or wind. On the whole, perhaps there is nothing more satisfactory than a pavilion, partially boarded or latticed up on the sides, with a good water-tight roof, and insect-proof screen over the openings all around. Some of the openings should extend to the roof, or ceiling, and some of them should come down to the floor. It is the lack of these that prevents a room being equal to an outdoor place; no matter how many windows there may be, there is a dead space above the tops of the windows where warm air accumulates, and there is a space between the bottoms of the windows and the floor where the heavy gases, such as carbonic acid, lie more or less stagnant until stirred up by some breeze of unusual strength or direction. Dust is also deposited in these dead air spaces. Anyone26 Milk Diet who has not tried living and sleeping in a space open from floor to roof, even on only one side, cannot realize what a constant difference there is between the air in such a place and the air in a room, no matter how well ventilated it may seem to be. A room is always more or less draughty, with the windows open, while in these outside places the circulation of air, while thorough, is almost imperceptible, so gently and easily is the change made. A great improvement in a room with sliding sash windows can be made by removing the sashes. Take off the thin strip called a “stop” on right side of window. Pull out bottom sash and remove ends of sash cord which are usually knots stuck in holes in sides of sash. Holding these knots, lower the sash weight inside of the casing as far as it will go. Put sash away in safe place. Now lower the upper sash to the window sill, and remove from right side the thin stick, “parting bead,” which keeps the windows apart. Then the upper sash can be removed just as the first one was. This gives the full size of the window opening, more than twice as much as when the sashes are in. They can easily be replaced in case of a storm. It is the retaining of the gases and other cast-off material from the body in the room that makes indoor life so much more unhealthy, compared with life in the open. The greater warmth, too, indoors, prevents the same degree of oxidation that is possible outdoors. The cooler the air, the better it is, as a rule, and the more oxygen we are able to absorb. There are probably other substances besides simple oxygen, in fresh air, that are necessary to our well-being. When you have decided upon a suitable location to stay in while taking the milk, arrange for a comfortablePreliminary Arrangements 27 bed, preferably one with a hair mattress. A hard bed, or a bumpy one, becomes irksome before the skin has developed the protecting pad of flesh that belongs over the bony points. The head of the bed should be toward the openings where the light and air enter. Do not make the common mistake of putting the feet out in the center space, in a current of air, and the head in some corner where the circulation is at a minimum. The reverse should be the rule. Beds with solid headboards or footboards should not be used. Procure an iron bed, or a couch or cot without any headboard. Of all things, do not attempt to sleep in a modern folding bed where the head is put in a boxlike space, eminently more suited to the destruction of one’s health than to its restoration. The bed clothes should be woolen blankets by preference, with cotton sheets, fastened at the foot, and folding down from the head of the bed, so that the patient can easily turn down a fold or two when less covering is required. In certain cases where this is much perspiration, or exhalation from the body, it is a wise plan to use a set of bed linen not over twenty-four hours at a time, not necessarily increasing the laundry expense, but putting one change of linen to air while the other set is in use. Remember that it is necessary to stay in bed all the time, except when bathing, or performing other necessary acts, and that the skin is an important breathing organ, and must not be surrounded by foul odors. The sleeping garments should be changed twice a day, morning and night. I think a gown is preferable to pajamas, because it is very important that there be no constriction around the waist. Garments requiring to be buttoned, or belted, around the waist, interfere28 Milk Diet with the proper development of the organs contained in the abdomen, and also prevent, to some extent, abdominal breathing. I am explicit about these directions, because a very rapid growth and development will take place in the organs of the digestive system, the stomach, liver, intestines, pancreas, etc., and this growth is greater in the first week than during any subsequent period. It is during this first week that the success or failure of the milk cure is usually determined, and this growth, or development, MUST not be interfered with. If possible, the patient should be within easy reach of the toilet and bathroom. There must be no dressing to go outside the room to a toilet. Have a capacious slop jar in the room and a urinal to use in the bed, especially in cold weather. By having the jar near the bed, the urinal can be used, and emptied into the jar, without getting up, or exposing the person. A small table, or stand, about two feet high, is required near the head of the bed, to set the milk can and glass on, and for such other small articles as may be required. A two-quart tin can, or measure, is the most convenient and best receptacle to keep the milk in at the bedside. It is lighter than any pitcher, and unbreakable. Have two napkins to cover the milk can and glass between drinks. Two glasses will be needed, marked in some manner to indicate 5, 6 or 7 ounces of milk. A ring can be scratched around a plain glass with a file at the proper point. An old established custom in the milk cure is that of using one glass for twenty-four hours, without washing. If the weather is very warm it is necessary to serve a clean glass with nearly every quart of milk, or the resi-Preliminary Arrangements 29 due remaining after drinking will sour the next glassful of milk. A clock must be located where it can easily be seen from the bed. Clocks striking the hours and half hours are a great aid in calling the patient’s attention to drinking time. Good clocks of this description can be purchased from two dollars up. Outside of the necessary articles mentioned, the less furniture there is the better it will be. Chairs for visitors are not particularly required, for there should be no visitors. If absolutely necessary, visits may be tolerated, but never for longer than half an hour at a time. A daily warm water bath will be required and the arrangement of the bathing facilities is one of the things that requires careful attention. It is necessary for the patient to enter the tub while the water is somewhat cooler than the body, and then gradually warm the bath to the body temperature, or to such a temperature as will be entirely comfortable. This necessitates a reserve supply of hot water, which may be drawn on at intervals during the bath, as the water cools off. The ordinary thirty-gallon reservoir, used in connection with a range in most households, is not often satisfactory, because drawing the necessary amount of hot water to prepare the bath leaves no surplus, and it is most annoying to open the hot water faucet and get cold water. However, if the tank is full of hot water, and the fire in the stove is kept going, it may work all right, but there must be hot water up to the end of the bath. The instantaneous gas heaters, if properly arranged, are satisfactory. If the heater is in the bathroom, it must have a flue carrying the fumes outside of the room. The best arrangement is to have a gas heater in connection with a30 Milk Diet reservoir, preferably in another room, so that the hot water when not being drawn into the tub, will be collecting in the reservoir. There is serious objection to having the water heating apparatus in the bathroom, unless the room is large and well ventilated. The heater uses up more oxygen than the lungs of several people would. Many fatalities have occurred in Southern California from instantaneous heaters, causing the asphyxiation of the inmates of bathrooms, perhaps chiefly on account of the habit some people have of shutting the bathroom up tightly while bathing. The tub itself is a matter of considerable importance. I have not yet seen a modern white enameled iron tub that seemed as satisfactory as the old copper tubs, chiefly on account of the shape. The iron tubs are moulded somewhat like a huge box, with flat bottom and vertical sides. Even the head of the tub where the bather’s head and shoulders rest, goes almost straight down, whereas the old style had a gentle slope about two and a half feet long, making a comfortable support for the upper part of the trunk and head. The copper tubs had a rounding bottom which fitted the body better, and did not require so much water to cover one, and the metal itself being thin, was rapidly warmed by the hot water, while the thick iron tubs now used require the expenditure of considerable heat simply to warm up the tub. The iron tubs stand up so high as to be difficult for a weak person to enter, and serious accidents have occured on account of the bather slipping as he left the tub. Another objection is the location of the overflow so near the bottom that the tub will only hold a few inches of water. This latter fault may sometimes be remedied by unscrewing the fixture and covering thePreliminary Arrangements 31 outlet with a thin rubber sheet, or filling it up with putty. Sometimes the overflow may be stopped by simply putting a piece of paper over it, when the force of the water will hold the paper tight against it. The tub ought to be deep enough and long enough to hold sufficient water to cover the shoulders when the patient is extended at full length, and for this purpose a six-foot tub is usually necessary. A five and a half foot, or even a five-foot tub, may be used by short people, or ladies, but the six-foot is best. A canvas head rest may be used, if necessary, or a rubber cushion, or hot water bag full of air, to rest the head on. The trouble with most ladies is that they object to wetting the hair, while men as a rule enjoy lying in the tub with the water up to their mouths, and it is best that all should do this. The patient should have a bathrobe to wear in going from the sleeping room to the bathroom, and a pair of easy slippers. Felt slippers are the best, as they do not require stockings, and are warm and comfortable. Hundreds of times I have seen patients, after taking a warm bath, leave the bathroom with only bathrobes and slippers on, go outdoors to their beds, in all kinds of weather, and I never knew any of them to “take cold.” In regard to milk, a few necessary general rules will be given here. What is required is good, clean milk as it comes from the cow, without the removal or addition of any substance whatsoever. Boiled, sterilized or pasteurized milk, or milk artificially preserved in any way, can not be used for this treatment. In well-managed modern dairies the handling of milk is so systematized that there is no particular trouble in keeping the milk sweet until used. Dairies that are not cleanly, or have not proper appliances, often use some means of preserving the milk, by stopping the32 Milk Diet activity of the acid-forming bacteria. These bacteria are not dangerous to health, and the methods of restraining or destroying them are without effect on the bacteria of consumption, typhoid or other fevers that might contaminate milk in certain places. Prolonged boiling will destroy any germ, but boiled milk alone will not sustain life in either the infant or the adult. Pasteurizing milk or heating to 150 F., or less, can have no effect on the pathogenic bacteria and renders it unsuitable for human use. Dogs fed on pasteurized milk only, are liable to have the mange and other disorders, while others of the same litter thrive on raw, sweet and sour milk. There are several chemical preservatives sold to dairymen by manufacturers who claim they are harmless. They are prohibited by the laws of most states. Some of them containing borax are not exactly poisonous in the amount one would ordinarily get in milk; but they render the milk much less digestible and in a weak baby or invalid adult might readily be the contributing cause of death. Others, like salicylic acid, or formaldehyde or formalin, are distinct poisons. There is no harmless preservative of milk; whatever prevents its decomposition will render it more or less indigestible. The manner in which milk is handled makes a great difference in its keeping qualities. Milk which is cooled and aerated immediately after being drawn, will keep for days; while, on the other hand, milk which is left to stand with the animal heat in it, will often be stale within twelve hours, and sour in less than twenty-four hours. Milk from Holstein cows is the best for the purpose, next that from Durhams or Shorthorns, and last that of the pure Jersey and Guernsey, or Alderneys, as the two latter breeds were formerly called. Milk from JerPreliminary Arrangements 33 sey cows may be used, but it should tbe skimmed after standing two to four hours to reduce the amount of cream. So important is this question of the kind of milk to be used in this treatment that I quote from an article by Professor J. Allen Gilbert, printed in the New York Medical Record, October 27, 1906, on “Choice of Cow’s Milk.” The italics are mine: “Holstein milk is characterized by fat globules of small and uniform size, separating slowly by the gravity method, churning slowly, and carrying very little color. Set side by side with milk of no richer quality but of larger fat globules, in a given time less depth of cream will rise. Holstein milk coagulates the most slowly of any, and on account of its small globules and their evenness in size it has a decided advantage in ease of absorption. “This breed can be traced back for two thousand years and was always famous for dairy purposes. In temperament these animals are quiet and docile, bulls as well as cows, the bulls exceptionally so. Instead of being held at bay with a long stick hooked in the nose-ring, they can usually be led out for exhibition at the end of a loose rope. Their robustness makes them specially resistant to disease, whereas the more delicate breeds, such as the Jersey, have sad tales to record from the ravages of such diseases as tuberculosis. “All in all, if one were choosing a human wet nurse he would look for just the characteristics in her that we find presented in a Holstein cow, viz., vigorous constitution, quiet, easy-going temperament, uninfluenced by external disturbances, good, glandular development, abundance of good milk, freedom from disease or tendency to disease, a good healthy child of her own, and good family history. “Whether we are to grant any such thing as a vitality peculiar to a milk or not is a disputed question. However, Professor Carlyle of the Wisconsin Experiment Station is quoted as saying that the Physicians’ and Surgeons Association of Chicago recommends the milk of a certain Holstein dairyman receiving 12 cents a quart because of some reason not understood it has more vitalizing power than any other milk they can get. “Those buying milk by the quart, sold at a uniform price for all breeds, will receive more commercial value by purchasing Jersey milk, for in so doing they get a milk with a higher percentage of solids. Where good digestion, adults eating a mixed diet, and highest commercial value per quart are the only elements to be dealt with in choice of a milk, t'h,e Jersey is undoubtedly the preferable milk. WHERE INFANTS, WEAK DIGESTION, AND LARGE QUANTITY OF MILK ARE AT STAKE, THE HOLSTEIN LEADS THE LIST AND THE JERSEY BECOMES THE LEAST DESIRABLE FOR NUMEROUS REASONS. “It is a well-known fact that certain Jersey cows give milk so rich in fat that they cannot suckle their own young. It is at least to be34 Milk Diet suspected that the trouble is not so much in the ‘richness’ of the milk as in the size of the fat globules. The smaller the globules of fat, the more permanent the emulsion, and also the less irritation to the gastrointestinal tract. Also, the finer the emulsion, the easier the process of digestion and assimilation. “The ingredient of our food which costs the most, which has the greatest physiological value, and which is most apt to be lacking in ordinary dietaries is protein. Skim milk has nearly all the protein of the whole milk. By removal of the fat in the cream it loses half its fuel value, but practically none of the protein. What is left has all the value of the whole milk for building and repair of tissue, for the making of' blood, muscle and bone, and half the value of the whole milk for supplying heat and muscular power. When the facts are fully understood, skim milk will doubtless be more widely utilized. “The average composition of buttermilk, which is practically sour skim milk, is quite similar to that of skim milk, though it contains slightly less protein and sugar and a very little more fat. The fuel value is about the same, about 165 calories per pint. An ordinary glass of buttermilk contains as much nourishment as a half pint of oysters or 2 ounces of bread, or a good-sized potato.” Many people anxious to gain weight think they should take all the cream possible. This is a mistake, as the fat in the milk does not normally make flesh in the body. The flesh built up on a milk diet is derived almost entirely from the proteins and carbohydrates, namely: casein, albumin, etc., and milk sugar. If the fat of a full milk diet was deposited in the body it would mean a gain of about half a pound of pure fat daily. The fat in cream has little or nothing to do with the cure of disease. Many of my best cases were cured on skim milk, even separator skim milk. The addition of Cream to the milk diet is an innovation which I do not approve of. Milk contains all the salts necessary for the building up of every part of the body. It has iron, potassium, phosphorus, sodium, lime, magnesium, fluorin, etc., and altogether contains about twenty elements. Dairy milk, or milk from a herd of cows, gives a more even average of fat and other contents than the milk from one cow would. There is no advantage inPreliminary Arrangements 35 having one cow set aside for your use, unless by so doing you secure Holstein milk. The milk should be delivered fresh, morning and evening, about two-thirds of the total quantity in the morning, and one-third at night. In the cities the milk is usually ten to fourteen hours old before being delivered. Many of my patients have taken the diet successfully under these conditions, but I think the average results are better with fresher milk.CHAPTER II. REST. THERE are a number of reasons why complete rest must be had, at least during the first part of this treatment. One very practical reason is the fact that many weak stomachs cannot retain the milk unless the body is lying quietly and therefore more or less relaxed. A stomach that has long been making an insufficient supply of blood is in a rut, and is disinclined to take more food, and thereby be compelled to make more blood. Practical experience has shown that if the body (and stomach) is kept as motionless as possible, the necessary amount of milk is much easier retained in the stomach and digested. The same principle holds good on a sea voyage. All old travelers know that lying down at full length in the berth until used to the motion of the vessel often prevents seasickness. Another reason is that naturally, in all animals, digestion and assimilation go on better while the animal is at rest, or asleep. With the whole body relaxed, there is not likely to be any tension on the valves or sphincters of the bowels, and consequently, movements of the contents of these organs are facilitated. Nearly all persons evacuate the bowels most readily in the morning after a good night’s rest, and very few people indeed have a regular movement in the afternoon or evening. The kidneys only do their best work while we sleep. It is a common experience for those who take time in the latter part of the day, either for a nap or simplyRest 37 to lie quietly and relax the body, to notice that as soon as the strain is taken off the external muscles, there is a •umbling and moving in the bowels which causes the jontents to pass through some previously obstructed dace. There is a very definite scientific reason why rest is jeneficial and work harmful in cases of injury or sick-less. Take the case of an injured hand, in which germs lave entered the tissues. Here the system marshals all its forces to destroy the invaders. If these forces can je concentrated upon this one task and not expended in part by the energy necessary to produce work, the chances of ultimate victory are greatly enhanced. Nature gives an imperative hint that the limb should be sept quiet by making movements painful; and most of latures hints are well worth heeding. But the most important reason for resting while taking the milk diet may be explained as follows: The treatment is taken to correct some function, or to develop some part of the body; something is wrong, or lacking, or needs rebuilding. In short, growth is necessary, and growth is always a function of rest. We may, by exercise, build up big muscles, but the growth even of muscles is performed between the periods of activity, for work always uses up energy and wears out cells. Continuous work, without relaxation, would be impossible for muscles or other tissues. The intervals of rest between the periods of work enable the blood to flow freely into the part and carry the needed nourishment to replenish the cells exhausted by the previous energy. Work may be the stimulant which causes subsequent growth, but in itself work is exhaustive, destructive. Recovery and recuperation can only occur during relaxation; we grow while resting.38 Milk Diet The body requires its night’s rest after its day’s work, and for the same reason a body weakened by a long period of strain, misuse, illness, must have a period of rest, in some measure proportionate to the period of wear. If, during this period of rest, there is an increased supply of nutrition and blood, we have the ideal conditions for rapid repair. With the wear and tear and waste of the muscular system stopped, the nervous energy which usually directs it is saved, or diverted to more useful purposes. The voluntary muscles are useful as organs of locomotion, prehension, etc., but they are not vital organs. Men have lived minus all four limbs. In chronic illness it is the vital organs that we have to deal with, those concerned with digestion, nutrition, respiration, circulation, innervation, and depuration. OBy putting at complete rest as many of the muscles as may be possible, we save a large amount of nourishment and nerve force that would otherwise be expended without any useful return. Every unnecessary drain must be stopped to allow the vital organs to rebuild and restore themselves. The more complete the inactivity of the external muscles, the brain and nervous system, and the sexual organs, the better prospect of restoring the normal functions of the other organs provided plenty of blood is supplied. I deem it an unfortunate, but unavoidable feature of the treatment, that the organs of generation almost immediately share in the general improvement, because it is undesirable, at this time, to spare any of the blood from the important work of reconstructing the digestive apparatus and the lungs (if there is a pulmonary disease), and there are too many men who cannot restrain themselves. Some people are unhappy with a few dollars in theirRest 39 pockets and won’t be satisfied until all is spent, instead of putting it in the bank and accumulating a good working surplus. I hope this simile will be understood and appreciated by married folk, and others. The success of the Weir Mitchell treatment is largely due to the complete rest prescribed for severe cases. For weeks these patients are not permitted to sit up, or sew, or write, or read. They are even fed by a nurse, and talking is prohibited. Complete rest on an ordinary diet usually means that massage will be required to move the bowels, but on the milk diet this is unnecessary, and unwise. No patient with dilated stomach, or prolapsed bowels, or piles, or prolapse of any organ, or high blood pressure, can be cured by the milk diet, if they are allowed to sit up, or walk around. My patients usually are allowed to read if there are no headaches, and the stomach is taking the milk without difficulty. But the reading should not be continuous. Read for ten minutes between drinks, then lay the book or paper down for fifteen or twenty minutes. Reading helps to pass away the time, and satisfies people who, without it, would want to be doing something more harmful. But read as little as possible, and never by artificial light. Talking is usually unnecessary and seldom beneficial. Don’t think because you are lying abed for weeks and keeping quiet that you will get rusty. I never knew the rest part of the treatment to do any damage; most of the patients are inclined to get up too soon, rather than stay abed too long. But they all store up energy while resting and the good effect is apparent as soon as they return to ordinary life.40 Milk Diet Many people with tired nerves and poor stomachs cannot take a sufficient quantity of milk to do much good without being completely relaxed. But this state of relaxation is a hard one for some people to get into. They don’t want to go to bed, and when they do, they stack up pillows behind their backs, until they are almost in a sitting position. They are losing half the benefits of the treatment, and the opportunity of a lifetime to take a complete rest. Isn’t it worth while to really rest for a few weeks if comparative comfort can thereby be secured for all the remaining years of life? To enable these folks to let go a little, to reduce the tension, the warm bath is of great use. In the warm ibath only do some of them first learn to relax. It is sufficient for some people, to tell them to lie out flat in bed, breathe deeply a few times, and then, beginning with the head and neck, relax all the muscles of the body, so that if the various parts were lifted they would fall like logs of wood. When all the muscles are relaxed there is a pleasant sensation, almost like floating in the air. Sleep secured after getting in this state is far more restful than where one simply drops off from fatigue, with all the weight of the day’s work and cares distorting the body. But many cannot properly relax at first. Here comes in the benefit of the warm bath. It is not “weakening” for these strained, nervous cases, any more than sleep is, but it does permit them to relax. Nothing supports the whole body so gently and easily as a good tub bath. I notice the insane asylums have grasped the idea, and many of them are fitting up bathrooms where nervous cases may remain continuously in the neutral bath for weeks at a time, eating and sleeping thereinRest 41 until the nervous system has recovered. The same method has been used since the world war to relieve the pain of severely wounded soldiers. Persons who have suffered extensive burns of the skin may be kept in the warm bath and avoid the use of opiates or oily dressings. The relaxing and soothing effect of the warm bath is due to several causes. It is sufficient to mention here the warmth, which relieves the body of its heat generating function; the moisture, which is absorbed externally and inhaled internally; the cleansing and opening of the pores of the skin, the softening and removal of the dead epithelial scales; the growth of new capillaries; the relief of pain and soreness and the wonderful buoyancy caused by the equalization of the pressure on the surface of the body. No cabinet, or vapor bath, or electric light bath can do what the warm tub bath does in combination with the milk diet. When the patient has learned how to relax the body, and really rest, I have little doubt as to the final result of the treatment. To illustrate the great difference in taking the milk diet, with and without rest, I obtained permission to quote the following case: Mr. Aubrey Parks, of Omaha, Nebraska, was attacked by acute nephritis, or Bright’s disease, about fourteen years ago. It ran on for several months and finally became chronic, with a great deal of dropsy, in spite of treatment in two hospitals and by several good physicians. He finally went to a sanatorium where the treatment consisted of a long fast, followed by an exclusive milk diet, a glass at a time, at frequent intervals, as I recommend. But, instead of resting, he was ordered to exercise daily, and went to the milk room every half hour for his milk. The result was that while42 Milk Diet his dropsy and albuminuria decreased somewhat on the fast, both increased markedly as soon as he started the milk diet. He was ordered to take another fast of about two weeks and then again took the milk diet, with no better results than before. Shortly afterward he wrote me about his case, without informing me, however, that he was not resting while drinking milk. I replied that I could not understand it, as I had never had a case of dropsy that was not cured on the milk diet. Mr. Parks finally made the long trip to California to take the treatment in the manner I recommend. On his arrival here September 1, 1909, he showed a condition of general anasarca, or dropsy, literally all over the body. He could not wear any of his regular clothing, hat, or shoes, on account of the swollen, waterlogged condition of his skin. His weight was 186% stripped, although he had been fasting several days during his journey. By my direction, Mr. Parks went to bed and remained there over a month, except for the time he spent daily in a warm water bath. He took from six to seven quarts of milk in twenty-four hours, and passed some days over ten quarts of urine. In fifteen days his weight had gone down to 127 —a loss of almost sixty pounds. From that time he slowly gained weight, up to 154 pounds of solid flesh, although the dropsy did not entirely disappear for several weeks, the ankles being the last to become normal. The albumin in the urine persisted for nearly the two months he was under my care, but finally disappeared. Mr. Parks, fourteen years after this treatment, is living in Long Beach and is quite well. He has just passed a rigid examination for life insurance. No medicine was used in his treatment.Rest 43 No case that I remember shows so emphatically as this one does the great benefit of rest while on the milk diet. ^Another case almost as instructive is that of Mr. S-----, of Iowa, who being attacked by a slight stroke of apoplexy, went to the same sanatorium that Mr. Parks took treatment in. Mr. S. knew that his arteries were in a diseased condition and this condition had no doubt caused the ruptured artery in the brain. He took the usual fast for about two weeks and then started in drinking milk, exercising vigorously every day, according to the system in vogue there. In less than forty-eight hours he suffered a second stroke which paralyzed his right arm and affected his speech—a result I should have expected under the circumstances, as the fast could in no way have strengthened his blood vessels to withstand the blood pressure consequent to exercise on a milk diet. This man came to me as soon as he was able to travel, in January, 1909, and after a short fast he went to bed and took five and a half quarts of milk daily for four weeks. I never had the slightest fear of another hemorrhage, because he was not making any exertion that could be avoided. After four weeks of rest and milk diet, I felt confident his arteries were in condition to stand exercise and gradually he began walking and using his arms. In less than a week, he could walk over two miles at a time, and soon after returned to his home. He wrote a few months afterward that he was resuming his occupation as a traveling salesman, and felt well. The amount of permanent benefit obtained from the milk cure is usually proportionate to the completeness of rest obtained. The less talking, reading, or muscular44> Milk Diet activity, the better the results. As far as possible, do nothing but drink milk and sleep. There is no danger of developing laziness. Everyone, at the close of a properly conducted milk and rest course, is stronger, more active, more energetic, more ambitious and has a better mentality, than before the treatment. All the organs share in the improvement, including the eyes, ears, skin, and sensory nerves.CHAPTER III. PSYCHOLOGY OF THE MILK CURE. I AM glad to say there is no “suggestion” or faith cure about the milk diet treatment. You put something in, and you get something in return for it every time. I have had patients who took the treatment because friends urged them to, but without the least faith in it, except that they thought “milk wouldn’t hurt them,” and these people have made as good a cure as others who had perfect confidence in the method. All my patients will bear me out in the statement that no psychological influence has been exerted. The milk diet treatment is a simple thing, and within any person’s reach. It is not necessary to have grand buildings, expensively furnished apartments, showy bathrooms, glittering apparatus, or complicated appliances of any kind. What is needed is a quiet, cool and airy place, with a comfortable bed and the necessary toilet utensils. A vase of fragrant flowers is always acceptable, but showy ornaments or pictures or lace curtains are out of place. Nor is it necessary to have frequent examinations of the body, of the urine, the blood, or the secretions of the stomach, etc. After a long sanitarium experience, and listening to the histories of many people who had been the rounds of the various institutions, I am firmly of the opinion that these “examinations,” as usually conducted, are mainly beneficial to the staff of young doctors who get the fees, and incidentally, some experience. Of what possible use is it for the patient to learn one week that he has “hypoacidity,” and the next week that he has “hyperacidity,” if his dyspepsia is not relieved?46 Milk Diet Such things may have their use in sanitariums conducted with the idea of having the patients stay as long as their money holds out, but they are not needed in a place where the treatment does what it is claimed to do, and patients are steadily improving. The average person will get better results in a well conducted sanitarium than he will at home, not especially on account of more skillful treatment, but from causes that are well understood by all physicians. The change of air and scene, the making a regular business of the “cure,” the relief from home cares and worries, the getting away from the well-meant but often harmful solicitations of anxious relatives and friends, often the exchange of a stuffy, over-furnished, over-curtained, badly ventilated bedroom for a more healthful one, all these, and many other details, frequently assist in getting an invalid started on the upgrade. But more than all other things combined is the wonderful influence of the new blood made so freely on the milk. Rest and quiet, daily warm baths, and plenty of fresh, pure air, are necessary to most people in order that they may take and assimilate the proper amount of milk, and eliminate the waste products. It is not necessary to have a daily “health lecture,” during this treatment, but frequently, at the start, a little encouragement is helpful to keep the milk going down, because the senses of hunger and thirst do not cry for it, and it is easy to stop drinking for a while. The best “cures,” in my experience, have been the patients who started in with the full amount of milk, and took it continuously, without interruption other than during the sleeping hours. They did not stop because their stomachs seemed full or for a bad taste in their mouth. Some of them have disregarded nausea and evenPsychology of the Milk Cure 47 vomiting during the first days of their treatment. Others have suffered headaches and backaches, and, later on, the dull, stretching pain in the stomach, kidneys and liver, which may accompany the rapid growth of those organs. Very many have had returns of the old pains of rheumatism, neuralgia, earache, toothache, pleurisy, peritonitis and inflammatory conditions of the generative organs, which they may have had years before. These pains usually last about a day, but in chronic cases of long standing, where there has been considerable growth of inflammatory tissue, and adhesions, as between the serous surfaces of the peritoneum and various organs of the abdomen and pelvis, the duration of the pain is somewhat in proportion to the length and seriousness of the disease. The pain is never as severe as it was in the original disease, except perhaps in some women at the menstrual period, and the pain may be stopped by stopping the milk, and thereby taking off some of the pressure, but that is usually the wrong thing to do, for it is the excess of blood that works the cure. I do not ask the impossible of any person, but I tell those who are inclined to stop the milk that the pain is only a necessary reaction in the diseased part; that pain means a growth of new capillary blood vessels in a place where the circulation has been stagnant, that the part or organ is growing larger, getting straightened out, coming back to the place where it belongs, stretching its fibrous and sensitive covering (as in the liver and kidneys), pulling on the contracted ligaments, or abnormal fibrous bands which have bound it down and interfered with its action, or stimulating the normal movement where it had been paralyzed. It is easier to understand why there should be pain48 Milk Diet with a curative process than it is to explain how there ever can be a cure without pain. When I have told patients what, to the best of my knowledge and experience, is going on, I leave it to them to decide whether they can stand the pain, or discomfort, with the expectation of a complete cure, or whether they will have to stop the milk temporarily, and perhaps stop the curative process when it is at its height. I encourage them by stating the fact, which I cannot emphasize too strongly, and which every one should remember, that in thirty-nine years’ experience with this treatment, on all classes of patients, suffering from heart and kidney disease, brain and nerve disorders, blood clots, paralysis, inflammation of the bowels, ulcerative processes in various parts of the body, chronic specific disease, dilated stomach, or chronic poisoning due to lead, mercury, arsenic, or any medicine, I have never known of any injury or bad results from pushing the milk diet, with the single exception of the hemorrhagic cases, such as those specified under consumption and high blood pressure. I would advise against giving the full milk diet to any patient who had recently been operated on, or who had a ruptured artery from any cause. I am not afraid to give the milk diet in any case of diseased blood vessels, or in aneurism caused by disease, for I believe the blood carries its own cure for these conditions, but COMPLETE REST MUST GO WITH IT. It is not possible in this little book to follow each case to the end. There is an infinite variety. If you have learned the great natural principles upon which the treatment is based and follow the directions I have given, you will be ready for any condition which may arise.Psychology of the Milk Cure 49 Don’t leave out some portion which you think is unnecessary, nor add something to it which has helped you under other circumstances. Try my way first. Those who take a full milk diet without resting, and fail to cure their disorders, should wait some time before taking the treatment in the proper way. It is best for them to lose the flesh they gained even if they have to wait several months, or take a long fast, before trying my method.CHAPTER IV. STARTING THE TREATMENT. IN SEVERE cases of illness, the success of the milk cure depends on the faithfulness with which the details are followed. Some of these details often seem unimportant to those who know little of the treatment, but, in any case, where a successful result has not been obtained, it has always been easy to point to faults of commission or omission. i It is true that many people have derived great benefit from a milk diet taken otherwise than as I advise, or only partially following my instructions, but I believe that the plan I give herein is one that is always successful, enabling the patient to take the proper amount of milk, and secure the desired results, without any danger. Before commencing the milk diet, it is usually advisable, and often necessary, to take a fast, from ordinary foods. For the ordinary case, where the digestion is more or less impaired, and particularly where constipation is present, the fast should continue at least thirty-six hours, but the patient is allowed to eat ripe fresh and dried fruits (except bananas) in such quantities as may be eaten with a relish, and as much water may be taken as possible with comfort. Diabetics should fast for five days, not even eating fruit. While I have started patients on milk only five or six hours after their last meal, sometimes I have regretted it and found that a day’s fast would have saved time. If there is a class of patients who can do without the fast, it is the thin, weak, anemic people, such as conStarting the Treatment 51 sumptives, neurasthenics, etc., especially those whose bowels are in the habit of moving freely every day. Such patients take milk greedily; they soak it up like a sponge, there is no initial constipation nor nausea, and the rapid increase in circulation causes a quick elimination of the impurities in the blood and bowels. On the other hand, those who are stout, plethoric, rheumatic, gouty, dropsical, constipated, or who have had skin or blood disease, diabetes, headaches, coated tongue, prolapsed or dilated stomach, or any displaced organ, should take at least one day’s fast, and many people will be benefited, and gain time in the end, by extending the fast over several days. Those who are not accustomed to fasting periods are usually agreeably surprised to find there is no particular inconvenience to this part of the program, and when the time comes to start in drinking milk, it goes down with a relish; the stomach makes no objection, and the bowels move naturally. Another important consideration is the fact that the organs of digestion are, so to speak, caught at low tide, at their minimum bulk and activity, and building up rapidly in size and function, as they do on the milk diet, while the mind and body are in a state of as complete rest as possible, there is a natural tendency to make good cells, good tissues, and healthy organs, and to overcome any abnormal habit or loss of natural function that may have been contracted by any organ. During the fast it is not necessary to take rest, or refrain from the usual work or habits; in fact, I think most patients are benefited by active exercise the day before commencing the milk. A few months ago I received a letter from a young lady magazine writer, who had taken a course of milk52 Milk Diet diet, after a fifteen days’ fast. She wished me to tell her of some way to prevent “decay of the teeth,” while on the milk diet. She claimed that cavities had formed in the teeth, not only in her own case, but also in the cases of a well known author, and his family, who had all taken the milk diet, after excessively long fasts. I was glad to be able to inform the lady that whatever deterioration of the teeth she had experienced, was entirely due to the fasting period, and not in the slightest degree to a milk diet. Some of her friends had fasted several weeks, until they were extremely emaciated, and, I believe, they had taken the milk rather irregularly, and usually started on only three or four quarts per day. In all my experience I never knew of anyone suffering the slightest damage to their teeth, during, or soon after, taking a milk diet. In my own case, my teeth were in bad shape before I took the treatment, and I had had a great deal of dental work done, but for twenty years afterward no dentist saw the inside of my mouth, as it was unnecessary. Several experienced dentists who have taken the milk cure fully agree with me in the belief that it is a great benefit to the teeth, either in young or old people, and that it can cure Riggs disease, or pyorrhea. Milk has all the elements necessary to build teeth with, and in fact, it is on an exclusive milk diet that babies grow teeth more rapidly, and more perfectly, than they ever do afterward, on any diet. Speaking of these long fasts, two, three and even four or five weeks long, I must say that I never saw any case that showed permanent benefit from them, and I certainly have seen a number of people who had hopelessly wrecked their health and even their minds by thisStarting the Treatment 53 unnatural starvation. Indeed, the mental condition of some of these patients who came from “fasting sanitariums,” was pitifully weak. Perhaps this condition was present before they fasted, and possibly it was owing to this fact that they were induced to continue the fast so long. I think I never ordered a longer fast than five days, but several years ago a young man insisted on taking a two weeks’ fast, under my observation. It was interesting and instructive to me, as I have been unable to find out from any book, or publication, recommending long fasts, just what happens to the functions of the fasters. This man remained in bed about two-thirds of the time, and at other times was taking rather long walks, about five miles daily. He took some light exercises several times daily, sat in the sun, read, etc. He had no serious disorder, was well muscled and nourished, but had a tendency toward constipation, and some lack of vigor not uncommon in men past thirty. About the third day of his fast, he was rather irritable and nervous and felt uncomfortable, but not hungry. After that he seemed fairly contented, except on the days when his bowels did not move, and on these days, or rather the next morning, his temperature and Llood pressure would show a considerable drop, while the pulse was usually higher at the same time. He had difficulty in keeping warm, although the weather was mild. I could not see that anything was gained by the fast beyond the fifth day, although he responded quite well to the milk diet that he took following the fast. During his fast he had a daily warm water bath, drank warm or hot water, and slept outdoors, with hot water bottles to make him comfortable.54 Milk Diet On the tenth day he took the juice of one orange; on the eleventh day the juice of five oranges, and the next day took two and a half quarts of full milk. Enemas were used several times to move the bowels, until he started on the milk, when the bowels began to move almost too freely. His vital functions showed the following reactions: Mouth Ounces Day Temper- of Bowels Weight Pulse Blood ature Water Moved Pressure 1 98.4 54 1 119% 66 130 2 96.6 60 1 116% 70 122 3 95.4 68 0 114% 64 122 4 94.8 68 1 112% 74 108 5 94.6 60 1 111 78 110 6 96 60 1 109% 74 92 7 95.5 50 1 109 60 100 8 95 52 0 108% 80 92 9 95.5 42 1 107 81 90 10 96.5 30 0 106% 82 86 11 96.8 milk 1 105% 70 106 12 95.4 80 0 105% 72 94 13...... 95.8 112 2 106 70 94 14 96 128 3 107% 72 94 15 96.2 144 2 109 74 98 16 96 160 1 109% 75 104 17 98.1 144 3 111 72 100 18 98 144 3 112 76 110 19 97.4 144 2 H2% 80 112 20 98.6 48 and 1 meal 2 113% 80 114 On account of the laxative effect of the milk a few dates were given with the milk, after the 15th day. In beginning the diet, take the weight in the morning, with as little clothing on as possible. Make a list of what you wear, and at the end of the week, wearing the same outfit, weigh at the same hour of the day. More exact results are secured by emptying the bladder each time before weighing. Measurements can be taken of the limbs, hips, waist, neck and especially of the chest, both expanded and contracted, and comparisons made from time to time.Starting the Treatment 55 In regard to the amount of milk to be taken, I will make the following statement: The average adult, when consuming daily two to four quarts of milk containing 4 per cent of butter fat and 9 per cent of other solids, will not lose flesh; with another quart or two they will gain weight, and with a still further increase of a pint or two they will secure the necessary energy and stimulation to throw off disease. There are several arbitrary rules as to the quantity necessary, such as taking an ounce and a half of milk for each pound of the normal weight or the highest weight in health, or, taking a quart of milk for every foot in height, but none of these will fit all cases. They are, however, a useful guide, especially in estimating the amount to be given children, when the first rule can be safely followed. The last thousand cases that I have had under observation have averaged about six quarts of milk daily, containing about 2 per cent of butter fat, and 9 per cent of solids not fat. The males usually go over that amount, and the average female patient will take slightly less. Lord Bacon in his Aphorisms says, “Many persons declare that they cannot take milk as a food, and the reason is that they do not take enough.” Dr. Stephen Smith of New York, in Dietetic and Hygienic Gazette, says his childhood experience at the farmhouse gave him a clew to the solution of Bacon’s unexplained maxim. Noticing that in making cheese the operator weighed first the milk, then the “rennet,” and recorded the result, he was led to inquire why so much accuracy, and was informed if there was too much “rennet” for the milk the curd would be so hard that it could not be pressed into a cheese, and that if there was too much milk for the56 Milk Diet “rennet” the curd would be so soft that it likewise could not be formed into shape. A very soft curd is necessary for digestion, while a hard curd prevents the penetration of the digestive fluids. Hence it is easy to see why it is best to take plenty of milk with this treatment. It is wrong, if not positively dangerous, to attempt the exclusive milk diet on any amount of milk less than that required to noticeably stimulate the circulation and promote body growth. A possible exception might be made in the case of convalescents from severe, acute fevers, where a few glasses of milk daily might keep them going temporarily until the ability to digest solid food was recovered. Even in those cases, water would be a safer drink, and probably would do as much good. There is no half-way method of taking the milk diet for people who have much the matter with them. Enough milk must be taken to create new circulation, new cells, and new tissue growth, and cause prompt elimination of the waste and dead matter that may be poisoning the system. A patient should start with the full amount of milk ; cases that begin on a smaller quantity and try to work up to the proper amount, often fail to get the best results. They get the stomach in the notion of taking three or four quarts, and then find it difficult to increase the amount, while those who start on, say, six quarts daily, have little or no trouble after the first day or two. In beginning in this way we take the stomach by surprise, and as the milk keeps coming, the stomach is compelled to dispose of it, and soon does so, in the natural way, without difficulty. It is rather common for patients to say, the afternoon of the first day, that they feel so full they cannot take another glass, but as theyStarting the Treatment 57 continue taking the regular quantity, ways and means are provided, and the sensation disappears the same day or that night, and does not return. On the contrary, if you humor the stomach, and stop when it desires you to, you will likely have to repeat the whole process the next day. It must be remembered that stomachs of this kind are not normal, and have been out of condition so long that they are not competent judges of what is best for them. When milk continues to come in and the stomach becomes over-distended, the lower outlet opens and allows some of the contents to pass into the intestine. This is desirable because milk can be perfectly digested in the intestine and the process stimulates and improves intestinal activity. Undoubtedly this action goes on in the case of the suckling babe and assists in rapidly developing its dormant digestive functions. If other food were taken with the milk this intestinal action would not take place satisfactorily, but with milk alone, digestion and assimilation may go on throughout practically the whole length of the alimentary canal. The addition of even a cracker to the milk seems to cause the stomach to hold all its contents for hours without discharging much into the intestine. Fruit does not have the same deterrent effect when eaten with milk, but it is not advisable to use fruit during the first few days of the start. On the morning the milk diet is commenced, the patient remains in bed and takes the first drink as soon as the milk is available, but starting on the even hour, or half hour, and takes the same amount every half hour. The next, the following day’s drinking begins as soon as the patient is awake in the morning, using the58 Milk Diet milk supplied the previous evening. The amount of milk taken in twenty-four hours is calculated from the time the first glass of the new day’s supply is taken, until the same time the next morning. If six quarts is the daily amount, use a glass marked to contain six ounces; if seven quarts is the allowance, take seven ounces in a drink. If five and a half quarts are taken, the glass should hold five and a half ounces, and so on. Using these amounts there will be thirty-two drinks taken in twenty-four hours. If the first drink is taken at 6 a. m., and none are missed, by 8:30 p. m. thirty drinks will have been taken, two to be taken any time in the night when awake. This is the only way that such an amount of milk can be absorbed by a weak stomach and it IS always absorbed, digested, or discharged, where the directions here given are followed. It is necessary to be exact as to the time and quantity taken. Each glass should be sipped slowly, taking several minutes to finish it. The milk must be mixed with the secretions of the mouth. Do not gulp it, or let it run down the throat, as you might water. Now and then I come across a patient who will take long draughts of milk, say two ounces at a pull, but drawn into the mouth in a rather small stream. They are young people with active salivary glands, and doubtless the action of sucking the milk through a small mouth opening at the same time draws saliva into the mouth. Such patients say the milk tastes better to them taken in that manner than it does where taken in small swallows and “swished” around in the mouth by the tongue, but the latter is the safest way to start on. A straw, or glass tube, or drinking cup may be used. Many patients sleep more than half the time. IfStarting the Treatment 59 asleep when drinking time comes, take your glass when you awaken, but do not try to make up for lost time. Continue thirty minutes apart. Milk is supposed to require about one and a half hours for digestion, and all dietetic plans before this have allowed at least that much time between meals. I use the half-hour interval because it gives the best results. Milk is probably curdled as soon as it arrives in the stomach; the sugar, albumen, salts and water begin to be absorbed immediately, other portions are passed on to the intestines, where the fat is quickly absorbed by the lacteals. The nitrogenous portions may not be taken up into the blood for twenty-four hours. So it is useless to set any particular time for the digestion of milk or other food. Doubtless a part of the milk will still be in the stomach at the end of thirty minutes, but its mixture with a fresh portion has no bad effect. On the contrary, it works well in practice. A patient, in describing the effect, once said: “After fairly started the first glasses seem to pull the others after them by suction.” If an invalid’s stomach is very weak, or particularly deficient in the digestive juices, and especially if the milk is taken too rapidly, tough curds, which are slow and hard to digest, may be formed in the stomach at first. In the vomit of persons who were drinking quantities of milk too quickly, or at too low a temperature, I have seen these cheesy bodies so large and firm that it seemed impossible that they could have come up through the oesophagus. Where the conditions that I recommend as to rest, bathing, air and the small, frequent and regular drinks of milk have been followed, I have never known of these curds being formed in such amounts as to prevent their digestion, with the exception of a few60 Milk Diet very weak people who were attempting to take their milk too cold. It would be a sad mistake if we were to give up the idea of a milk diet because of a few curds in the stomach at first. It is also a mistake to peptonize the milk, or to add anything to it, to make it easier to digest. Let the fact be recognized that the fault is with the stomach and not with the milk. It is purely a functional fault and must be corrected, and, when the stomach is able to handle the milk right, it will also be able to digest ordinary foods as well. There is seldom any difficulty in taking the milk after the first day or two if the start is made under proper conditions, and, after that, all that is necessary is to continue building up the digestive organs and the system generally by three or four weeks of this plan of treatment. I usually start patients on milk which is near the room temperature, or at least not below 60 degrees F., but if there are symptoms within the first two or three days of indigestion, distress in stomach, nausea, or vomiting of thick curds, the patient goes on warm milk immediately and does not take any cold milk for several days. In cold weather, if any trouble of this kind is anticipated, it is better to start on warm milk at the beginning, but in most cases, especially in mild weather, it is unnecessary to warm the milk. On cold nights, if drinking the cold milk prevents the patient getting to sleep again, provision should be made for warming it. The most satisfactory way of warming the milk is to have a pan containing about three inches of warm, almost hot, water, and set each glass of milk in it forStarting the Treatment 61 two or three minutes until it is warmed through. The milk ought to be about blood heat, although it can be heated in this way to 115 degrees without harming it, but the milk must not be left long in the water, and must be taken immediately. No more than one glass can be heated at a time. The most convenient way of keeping the pan of water hot is a small oil stove, kept burning continuously at such a heat as may be necessary. An electric plate can be used. If the patient has no nurse the whole arrangement must be set near the bed so the patient can prepare the milk without getting up. Taking this warmed milk, according to the other directions, indigestible curds are never formed. Do not let these patients take a glass of cold milk early in the morning, as it might affect them all day. It is not practicable to use thermos or vacuum bottles to keep warm milk in all night because the milk would spoil, but a bottle of hot water, or several of them, can be arranged for the night, and a glass of milk warmed at any time by emptying the hot water into a small pan, and setting the glass in it. The secretions of the mouth may have no digestive action on milk, as there is no starch in the latter, but the mechanical effect of the addition of the fluids is important. Outside of the milk cure, some weak stomachs can take milk diluted with water, and assimilate it, where straight milk disagrees. Infants are usually given milk largely diluted with water, but a healthy infant can generally take pure milk without trouble. In any case the water should be gradually reduced and omitted as soon as possible. Skimmed milk is easier for a weak stomach to digest than full milk. Milk from which the cream has been extracted by a centrifugal separator just after milking, is better for dietetic purposes than62 Milk Diet ordinary skim milk (except for diabetics) and either is preferable to milk diluted with water. The taking of at least one or two drinks during the night is a valuable assistance in getting down the necessary quantity of milk. Constipated people should never omit this. It is not necessary to give the stomach a rest while taking the milk cure. It does not need a rest on an exclusive milk diet any more than a baby’s stomach does. Other organs are resting, but the stomach is being built up to a state of maximum efficiency. It is very unwise to omit drinking the milk at a regular time because you don’t feel like taking it. If the stomach has been out of order for a long time, there may be a good many disagreeable symptoms, such as bad taste in the mouth, thick coat on the tongue, gas on the stomach, with considerable pain, nausea, and even vomiting, but none of these should prevent the patient taking the regular drinks. The omission of a glass or two, instead of making one feel more comfortable, really has the opposite effect, because the constant, regular procession of milk through the alimentary canal is interfered with, and it begins to “come back,” when, if the milk was kept going down, it would carry the gas down with it into the intestines, where it belongs. The acidity of the stomach is also increased by interrupting the regular drinking. If, in a case of this kind, the milk is stopped for some hours, all disagreeable symptoms cease, and the patient will find he has a better stomach than he had before starting the treatment, but the cure has only been a partial one, and it may be even harder to get over the critical point next time. It takes a long experience in this work to give one the necessary confidence to tell a patient to continue the treatment under these circumstances, but it is anStarting the Treatment 63 absolute fact that I have never seen any harm result from sticking to the diet (while resting), and the troubles are only the natural explosions due to the revolution going on in the stomach. If there is any better way to cure an old chronic case of indigestion, with a shriveled up, weakened and almost juiceless stomach, I have never discovered it. If the patient is lacking in will power, and cannot, or will not, take the regular amount of milk each time, it is a great deal better to take half a glass than none, and resume the full amount at the earliest possible opportunity. Fortunately, there are very few people who have such a hard time on the milk diet, and they are most all elderly people who have been in ill health for many years. But even in this class of cases, less than two per cent have failed to carry on the treatment to a satisfactory result. The patient must have a warm bath daily, and it is usually taken in the forenoon. When there is any tendency to insomnia the bath can be given in the evening and usually has a good effect in overcoming that trouble. The first bath should last only fifteen or twenty minutes, increasing the time about fifteen minutes every day until the patient is staying in the water at least one hour. Use no soap in the bath. These three items in regard to the temperature of the bath water must be remembered: Start slightly below body temperature, Increase to the body temperature, Finish almost hot (but never hot enough to cause dizziness). The bath should be prepared with a temperature of 94 or 95 F., and, as soon as the bather becomes accus64 Milk Diet tomed to this sudden change from the air temperature, he should gradually add hot water until he feels perfectly comfortable, neither hot nor cold. The thermometer will then indicate about 98 or 99, although people differ several degrees in their sensations. The temperature must be kept at this point until nearly ready to leave the bath; then hot water should be added to produce a thoroughly warm feeling throughout the body. In very hot weather I have found it wise to reduce the temperature of the bath at the start a few degrees— to abstract heat from the body instead of adding it. The principle to be followed is to keep the patient entirely comfortable, and if, for any reason, he is not comfortable, he should get out of the bath. Having the water too hot on entering will cause a slight attack of indigestion, in the same way that a hot bath affects one when taken too soon after a full meal, because the blood is drawn to the skin, and away from the internal organs. The bathroom must be ventilated in every way possible, and the milk taken at the regular time while bathing. Ladies who object to wetting the hair can wear rubber bathing caps, but it is better to do without them. The circulation of the blood in the scalp is so much greater than usual that the warm skin dries the head rapidly and there is no discomfort where the hair does not have to be “put up” immediately. With very serious cases it is better to cut the hair to a convenient length; it grows rapidly and will be much stronger. In any case the hair ceases to fall out, for it responds quickly to the general condition of the body. Regarding bathing by females during the menstrual period, I will say that I have never known of any harmStarting the Treatment 65 ful results from the practice, but if ladies prefer, the baths may be omitted for a few days at this time. The following item in this connection is from the Nursing Times: A cold bath or sea-bathing will sometimes cause the suppression of the menses, but this does not apply to the ordinary warm bath which so many women quite erroneously consider should not be taken during the progress of a menstrual period. There is not the slightest justification for depriving oneself of this source of comfort and cleanliness. It can do no possible harm.—Nursing Times. One need not be afraid of putting the ears under water. If the eardrum is perforated the ear can be plugged temporarily with cotton. I have seen deafness unexpectedly cured by the combined diet and bathing while undergoing treatment for other diseases. The proper way to take the bath is to have enough water to submerge all of the body except the face and he at perfect ease with all muscles relaxed - and the shoulders supported by the sloping head of the tub, or some contrivance such as a water bag, air cushion or canvas strap. Do not keep the head bent forward at an unnatural angle to keep it out of the water. Breathe deeply and occasionally sink the face under water, closing nostrils, if necessary, with the thumb and finger. On finishing the bath do not use cold water or the shower bath, and if possible avoid draughts of cold air, not from any danger of “catching cold,” but to prevent the stimulation to the skin. The reasons for giving baths of this description, and the benefits derived from them, will be explained in another place. I will only say here that I would not undertake to give the milk and rest cure without the aid of these baths. On getting out of the tub, the patient should dry himself with a soft towel, without unnecessary rubbing,66 Milk Diet or exercise, put on his bathrobe, and return at once to bed. Weak patients may have the aid of a nurse in drying the skin and returning to their apartments. I think the minimum time for a milk diet course should be four weeks. Three weeks should be devoted to the rest cure, and the remaining week will be sufficient to gradually get the patient up, and on solid food. In a considerable number of cases patients may continue using milk as a diet, if their circumstances permit, after resuming their occupations, or ordinary habits. I have letters from different people who state that they have lived on milk for long periods, often several years, in one case twenty-one years, in another fifty years. All these persons began the use of milk for some serious ailment, and yet every one of them seems to be in a state of vigorous health and vitality now. The case of Dr. Herman Schwartz, an Austrian physician, who has lived on milk exclusively for twenty-three years, is interesting, as from all accounts he is in the best of health and strength. He is said to take three gallons daily. One of the best public speakers on the Pacific Coast has lived wholly on milk for four years. I have just received (1913) the following letter from Mr. W. F. Kitzele, of North Third Street, Burlington, Iowa: “I have lived on a strictly milk diet for the past forty-two years, not as a matter of choice, but from the fact that I am unable to take solid food of any kind, even a crumb of bread. “At the age of two years I took a dose of concentrated lye, which caused a stricture of the food pipe and since then have lived on a milk diet, and I believe have gotten along better than the man who eats. I am five feet, six inches tall, weigh one hundred and forty pounds, and am married and have four strong, healthyStarting the Treatment 67 children. I take one quart at each meal time and none between meals. My health is good, in fact I have never been ill in bed in forty-two years.” This case is so interesting and instructive that, in preparing the tenth edition of my book in 1921, I wrote to Mr. Kitzele, who occupies a responsible position in his city, and asked him for more particulars of his case. He has very kindly given me the following data: He is still living on an exclusive milk diet, and will do so for the balance of his life. It is now fifty years since he has tasted solid food of any kind, his only diet being one quart of milk, three times a day. He never took more than this amount; may have taken less when a child. He does not drink much water, not a gallon a year; never gets dry. In the fifty years he has never been confined to bed by illness, and, physically, is as strong as any man doing office work. Mr. Kitzele is convinced that most of the ills of life are caused from eating improper food. (And I agree with him.) Regarding his bowels, he states that he has absolutely no trouble. They move twice each day as regular as the clock. At one time Mr. K. was acquainted with a Mr. Castel, of Chicago, who was in the same condition, from the same cause, and also living exclusively on milk. I would like to hear from Mr. Castel. The small amount of milk that Mr. Kitzele finds ample for his needs is surprising to me. As he began the diet when an infant, he accustomed himself to an amount that would, according to my experience, be inadequate for an adult. Or, are we adults using too much food? If milk can be taken often enough one can endure more cold than on any other diet. I have lived in the open air in winter with patients where we had to thaw68 Milk Diet the milk before we could use it. You can get more energy and heat out of a quart of milk than an Eskimo can out of a pound of blubber. I can state here as a positive fact that an immense amount of physical or mental labor may be done on a milk diet. A young friend of mine lived on about five quarts of milk per day during two terms of college just before graduation and won second honors in a class of over three hundred, and finished in fine physical condition. His board cost him about $10 per month. Professor Weir Mitchell in “Fat and Blood,” page 125, says: “I have seen several times active men, even laboring men, live for long periods on milk, with no loss of weight; but large quantities have to be used—two and a half to three gallons daily. A gentleman, a diabetic, was under my observation for fifteen years, during the whole of which time he took no other food but milk and carried on a large and prosperous business. Milk may, therefore, be safely asserted to be a sufficient food in itself, even for an adult, if only enough of it be taken.” The gifted writer, Mrs. Ella Wheeler Wilcox, wrote me as follows in 1905: “I believe in the milk diet, because I have taken it with results so marvelous, and so beneficial, that all Mr. Rockefeller’s money could not repay me, were I deprived of the knowledge that I gained by the experience. A man of my acquaintance who destroyed his digestion by years of wrong habits, has lived for the last five years in perfect health and strength on milk alone. He is able to work more hours with less fatigue, than any of his acquaintances. He possesses a marvelous complexion and is never ill. “Another friend who had been a hopeless invalid for ten years, through complications of diseases, has lived on milk for three years, and finds herself perfectly wellStarting the Treatment 69 unless she attempts to return to solid foods. A dozen skilled physicians failed to give her even three days of health, until she gave up foods for milk. Seventeen other personal friends restored their health, and the ability to digest a natural, varied diet, by taking the milk treatment for a few weeks.” Where it is the intention of patients to keep on with the milk diet for very long after stopping the rest cure, it is advisable for them to take larger doses, at less frequent intervals. Some patients who had been a long time on a half-hour schedule, with a corresponding amount of milk, have said that they found it difficult to eat enough food at one time to last them until the next meal. There is usually no difficulty in taking twice the regular quantity of milk every hour instead of half as much every half hour. This gives more time between drinks for exercise, or business affairs, and, I think, tends to fit the stomach better for distension of a regular meal, when ordinary diet is resumed. Business men often carry a handbag full of Mason pint fruit jars, containing milk, and drink one of these at convenient times. Quite a number of old patients have been able to drink a quart of milk at one sitting. But these experiments must not be tried until the stomach is taking the small and frequent doses without any discomfort, and the bowels are moving regularly. If the stomach is not handling easily the smaller drinks, it will be of no use to attempt the larger ones. A course of four weeks should ordinarily be sufficient to cure any of the following diseases: Nervous prostration, general debility, autointoxication, mild skin troubles, such as pimples, eczema, sallowness, wrinkles, etc., simple anemia, catarrh, biliousness, ringing in the ears, pleurisy, constipation, dyspepsia,70 Milk Diet indigestion, asthma, hay fever, piles, insomnia, ulcer of the stomach, colitis, or ulceration of bowels, goiter, malaria, arterio sclerosis (hard arteries), neuralgia, neurasthenia, acidity of stomach, chronic appendicitis, arthritis, urticaria or hives, cystitis, carbuncles, diarrhea or dysentery, dilation of stomach, gastritis, gout, impotence, neuritis, lumbago, sciatica, migraine, leucor-rhea, enlargement of prostate gland, tobacco, morphine and cocaine habits, gallstones and liver disorders, rheumatism, kidney disease, and the first stage of consumption. In colitis, if the condition of the stools does not indicate that the bowels are perfectly healed at the end of four weeks, the diet and rest should be continued longer, but the amount of milk taken may be decreased about one-third, and buttermilk may be substituted for some of the sweet milk, if it agrees. In more advanced cases of consumption or other chronic organic diseases the diet can be continued as long as visible improvement is made, or until cured. It may be well to say here that there are crises that come on in the course of the treatment, due to the revolution that is taking place in the body. None of them is an indication to stop the milk, quite the contrary. The most common formerly was an eruption on the skin of the face, body or limbs, usually coming out during the second or third week. I have seen large pimples and boils, but none that ever left a scar. Since I have been using the Holstein milk exclusively these eruptions do not occur except in patients who have previously been afflicted with them. Rheumatic patients nearly always have some of the customary symptoms or pains in the parts affected, but usually only once. I wish to speak particularly of crises occuring in speStarting the Treatment 71 cial organs that are or have been the seat of disease. You may think there is a recurrence of the disease, but do not have the slightest fear. After the inflammation or excitement has subsided the part is always in a better condition and probably entirely healed for the first time.CHAPTER V. REACTIONS DURING TREATMENT. BEFORE taking up the consideration of the different diseases, I will here describe some of the reactions that take place on a full milk diet. The great majority of cases of chronic disease, without fever, have defective circulation of the blood. The heart beats feebly or slowly, and there is actually too little blood in the arteries. The blood pressure is too low, perhaps 40 or 50 degrees below normal. The entire body is poorly nourished and unable to throw off the disease which afflicts it. • In these patients we notice directly, in every case, a most remarkable change. Within two hours after commencing the diet, the action of the heart will be accelerated, and within twelve to twenty-four hours there will be a gain of over six beats to the minute. Within two or three days there will be an increase of about twelve beats to the minute; the pulse will be full and bounding; the skin flushed and moist; the capillary circulation under the fingernails, or wherever it may be examined, quick and active. The blood pressure will have raised ten to twenty degrees. All this takes place with the patient lying as quietly as possible, making no movement unless necessary—conditions under which normally on an ordinary diet, the circulation would be much slower than usual. No one can deny the benefit of this condition in chronic disease. It is a result sought by every intelligent doctor, knowing that through the circulation only can chronic disease be cured. None of the usual methods ofReactions During Treatment 73 heart stimulation, such as alcohol or other drugs, exercise, massage, hot and cold baths, inhalations of oxygen, solutions injected into the veins, or transfusion of blood can equal the results of the milk diet treatment in effect, in permanency, in total lack of danger. This natural, physiological increase of circulation results from the increased amount of blood, created in the natural way, by the stomach and intestines, acting on an easily assimilated food. Physicians, investigating the milk cure, say that one of the most striking things about it is the quick return to a normal condition of the blood pressure, no matter whether it is too high, or too low. The blood pressure is entirely independent of the pulse rate. A very high, or very low blood pressure may exist with either a slow or a rapid heart. In anemia, consumption, auto-intoxication and wasting diseases generally, the pressure is away below normal. Persons subject to hardened arteries, apoplexy, Bright’s disease, asthma, bronchitis, etc., frequently have a very high blood pressure. Pressure varies somewhat according to age, registering on the instrument designed for that purpose, less than 100 degrees in children, and gradually increasing, until in the aged it may be over 150 without the health being seriously affected. In examining the records of the patients for 1915 I was astonished myself to see how every one of them with either a low or high pressure, tended to gravitate up or down, until they struck about the normal, which is probably around 130 for a middle aged adult. In some of these cases, especially of low pressure, the normal amount was not reached during their four weeks’74 Milk Diet term of treatment, but I think that all of these made farther gains on resuming normal habits of activity and diet. The records were taken about every seven days, the first or top one showing pressure on starting treatment, and the last one, the record on leaving. The table includes twenty of the unusual pressure cases under my care during the year. These tables do not do full justice to the improvement made. All of these patients with extra pressure had been running higher than the starting figure indicates, as the first record was taken after a fast and a night’s rest. Case No 166 203 204 205 207 Start 190 160 94 90 150 1st week 176 140 108 94 134 2d week 159 140 110 100 132 3d week 140 110 114 125 4th week 140 i40 116 120 125 Number 166 returned for examination one month afterward, and the pressure was 136. Case No 240 249 251 259 271 Start 206 100 102 84 160 1st week 192 140 90 154 2d week 172 126 ii6 100 144 3d week 162 128 116 116 4th week 156 130 118 116 132 Case No 283 292 297 299 301 Start 80 170 118 90 210 1st week 110 156 120 124 216 2d week 122 140 126 124 160 3d week 128 128 152 4th week 124 140 128 130 146 Number 301 got a bad start on account of not fasting long enough, and not having his bowels cleaned out, although he had taken a cathartic the day before coming. This was a bad case of kidney, liver and bowel disease.Reactions During Treatment 75 Case No 304 307 312 329 335 Start 160 114 92 100 160 1st week 140 130 116 116 146 2d week 136 120 118 140 3d week 134 120 135 4th week 130 i30 i.22 122 135 I add twelve more cases, one from each month of 1917. Case No 8 46 62 91 135 152 Age 54 55 46 33 77 59 Start 240 210 80 74 210 210 2d day 234 4th day 226 iso 6th day 220 ioo 7th day 82 iso iso 9th day 200 i40 12th day 196 15th day 190 146 108 ioo ibo i40 21st day 184 112 110 142 132 28th day 178 i24 114 112 138 136 Case No 208 216 245 284 312 363 Age 52 45 58 52 45 59 Start 92 100 180 210 90 162 7th day 110 105 162 196 96 142 14th day . 105 115 152 190 102 21st day 118 118 140 184 110 138 28th day 118 120 140 170 114 136 Of the above cases, No. 284, a man whose pressure had been 300 and who also had Bright’s disease in an advanced form, should have taken a longer treatment, for after several months he reports eye symptoms due, probably, to the kidney trouble, and his blood pressure is up to 190. As long as a patient is doing well, and making steady progress toward a normal pressure, the treatment should be continued, but the regular four weeks’ course is generally all that is necessary. There is no dangerous strain on the heart, in this treatment, because the heart itself is the first organ to share in the benefits derived from the better blood circulating through it. There is no greater stimulant for the heart than milk; there is nothing that will build up the heart like milk, but in all cardiac disorders complete rest must be combined with the diet. Many patients with serious diseases of the heart, organic or functional,76 Milk Diet valvular or nervous disorders, have taken the milk diet and I have never heard of any but good results. The resting patient can stand a full milk diet and benefit from it, but if the milk drinker’s heart is compelled to furnish blood to exercising muscles or an active brain, it may be too great a strain on it, at first, and tend to prevent the recovery of dilated, fatty or otherwise diseased hearts. In certain diseased conditions of the body there is an unusually fast pulse. This is always to be expected in fever of any kind, but there are certain disorders which are accompanied by a very rapid pulse, and yet the temperature remains normal. Exophthalmic goiter (Grave’s disease, Basedow’s disease) is characterized by so rapid a pulse that it is termed cardiac palpitation, but on the milk diet, resting, the heart slows down gradually but surely, and permanently. The same result follows in patients with fever or toxic conditions of any kind which cause a rapid pulse. So here again we see a return to the normal, although the condition is apparently the reverse of the slow heart. It simply shows how a natural remedy will restore the system to health, no matter what the symptoms may be. In taking the milk diet there is no danger to the kidneys, in spite of their greatly increased work, for invalids with badly diseased kidneys take the milk diet successfully. Some patients, it is true, have slight pains in the kidneys during the first days of their treatment. It is always temporary, and due, I think, to a rapid growth of the organs, so rapid that the sensitive covering of the kidneys is stretched tightly at first.Reactions During Treatment 77' About five years ago a physician’s wife was brought to me to be strengthened up for an operation on a tubercular kidney. A well-known specialist had made the diagnosis and it was supposed the only thing to do was to remove the kidney. She was on the milk and rest treatment not quite four weeks. On re-examination no trace of the disease was apparent. She has never had the operation, and continues in good health; in fact, has since given birth to a healthy baby. The amount of urine is very much increased by this diet, and no matter what its previous condition, whether highly acid, or loaded with solids or salts in solution, it becomes bland, non-irritating, and almost as clear as water. The frequency of urination is a little troublesome at first, but in a few days the bladder seems to be able to retain a larger quantity without discomfort; more fluid leaves the body in the perspiration, which is increased by the improved capillary circulation in the skin, and probably the lungs throw off more moisture. However, even then many patients will find it necessary to get up in the night once or twice. It is not advisable to hold the urine very long, as a portion of the water may be absorbed into the system. It is really wonderful how the various parts of the body accommodate themselves to the great changes which they undergo on the milk diet. It is only possible because the greatly increased blood supply brings with it all the necessary materials to make these changes, and a plentiful supply of nourishment for every cell, of every tissue.78 Milk Diet In ill health there is always one or both of two conditions of the blood, viz.: Insufficient quantity, Abnormal quality. Disease is a result of a disturbance of the mechanism of nutrition. There may have been predisposing or exciting causes in the way of bacteria or heredity, bad food, air or habits, but as the abnormal condition becomes apparent to us, we see the evidence of some disturbance of the processes of nutrition. There is a continuous battle on between the forces that build up and the forces that pull down; between the cells that do good and those that do harm. Nature is always endeavoring to maintain a normal standard against any agent or condition that may attempt to alter it. And when temporarily or accidentally that standard may be departed from, we see immediately an attempt to repair the damage. No matter what the abnormal condition may be, whether a cut or bruise of the skin, an ulcer in the lung, or the presence of some poison in the system, there is a continuous effort on the part of the natural forces, always acting through the circulation, to restore the normal condition, and we can assist that effort by supplying food that may be easily turned into good blood. On the condition of the blood depends the outcome of the struggle, whether life or death, a short or long illness. The circulation of the blood is natures agent in eliminating disease, and increasing the quantity and regulating the rapidity of the blood current while improving its quality will assist that elimination. In a great many maladies, whether caused by errors of diet or not, the digestive or blood-making power isReactions During Treatment 79 weakened, and to continue the usual food, or to take mixtures of meat, eggs, starchy materials and various drinks, including milk and alcoholic beverages, increases the burden on organs already overtaxed. If, in addition to the mixed diet, the patient is given medicines for the relief of pain, or for the reduction of temperature, stimulants or sedatives for the heart, cathartics for the bowels or diuretics for the kidneys, expectorants and emetics, hypnotics and narcotics, etc., any one or more of them, the problem for the circulation to solve becomes indeed a complex one, for each and every medicine must act through the blood, whether given by the stomach or through the skin. Even such a simple hygienic measure as bathing, by bringing the blood to the skin and away from the internal organs, interferes with digestion, if that process is not already completed, or of the most simple character. The action of the heart, as I have said, is usually accelerated, soon after commencing the milk diet. There is no reaction from this condition. The effect continues with the diet, but after a varying time the heart may slow down a little because it has become strong enough to do the work with fewer pulsations. The arteries continue full. The heart hypertrophies physiologically, just as a woman’s heart does in her first pregnancy. I have observed it many times. In health every organ in the body is hyperemic, or congested with blood, when in active operation, and as the activity increases, so does the blood supply. There can be no growth, or rebuilding, or regenerating of any portion of the body, without an amount of blood being present in excess of the ordinary tissuenourishing quantity. A condition of anemia, or lack of blood, will never80 Milk Diet be found when the body is successfully overcoming disease. We hear a great deal of hyperemia as a curative agent, following the ideas of Professor Bier, and using hot air apparatus to cause a local congestion of the diseased parts. The use of such apparatus indicates that the natural circulation is defective and unable to push the necessary amount of blood into the part. But in thus interfering with the circulation, how can we be sure that we are improving matters? Do we know how to force just the proper amount of blood to a diseased part? Where does the blood come from? Is not the remainder of the body weakened, or left without protection? Does not such apparatus bring the blood more to the surface and away from the deeper and perhaps diseased parts? Why not increase the blood supply naturally all over the body? Why use apparatus to cause a local congestion when there is a well-known function of the body to attend to just such things, if given the material to work with ? When we suffer an injury to any portion of the body, such as a bruise, a burn, a foreign body needing removal, or the presence of irritating bacteria, or their products, we do not have to wait for the application of any artificial apparatus. The congestion begins at once, through the vaso-motor system, ordered and controlled by the sensory and sympathetic systems of nerves. There is never any mistake about it; the congestion appears promptly in exactly the right spot and no other. Suppose harmful material has gained access to theReactions During Treatment 81 circulation, be it chemical, bacterial, or simply a loading up with the natural poisons of the body which have failed to be eliminated. Fever results. Fever is only a name for general hyperemia, and hyperemia is absolutely necessary to throw off or neutralize the poison. If there is enough healthy blood present in the circulation, or if it is manufactured as rapidly as may be required to carry off the poisons, the system is able to overcome the danger and restore the normal condition. New and healthy blood is necessary to perform cures; old blood, stagnant blood, impure blood (from improper foods), no matter how much of it there may be, is ineffective. In dropsical effusions there is always plenty of blood fluid, but of such a character that the hyperemia set up to repel disease only makes the tissues waterlogged. Place such a case on the milk diet, under proper conditions, and you will find that the dropsy is rapidly cured. The heart-beats vary greatly in number in different persons. I have started several patients on the milk diet whose customary pulse rate was around forty per minute. One lady started with thirty-six, and before the end of the first week showed about seventy-five per minute, while resting in bed and exerting herself as little as possible. From being a chronic invalid, almost bedridden, weak, listless, almost bloodless, without appetite, she became a strong, well woman, and has never lapsed to her former condition. In patients with fever and rapid pulse on the milk diet there is usually a slowing of the heart and nearly always a reduction of the temperature. The effect is chiefly caused by the larger blood current more easily removing the fever products, and by the cooling of the82 Milk Diet blood through dilation of the cutaneous blood vessels, and by increase of perspiration. One young lady with goiter started with a pulse rate of 135 per minute, but it gradually reduced to 80 at the end of the fourth week. It is very unusual for a patient to have a temperature above the normal while on milk and resting, no matter what the previous condition may have been. If the fever does not stay below 100 soon after the patient’s bowels are moving naturally, a serious condition is indicated. The stimulation of a full milk diet is very similar to the primary effects of alcoholic stimulation on the circulation, but the after results are entirely different, due to the fact that the blood carries with it the food necessary to repair the increased tissue waste. Stimulation by alcohol is followed by a period of depression which is impossible with milk. Continuous stimulation by alcohol causes inco-ordination of muscles, which never follows that of milk. Indeed, the spasmodic, uncertain movements of the hand in writer’s cramp may be permanently cured by a proper milk diet. The effect on the lungs is to quicken the breathing at first; then as the respiratory muscles strengthen, the inhalations become deeper. No matter what disease one may have, the breathing capacity is increased. The circumference of the chest enlarges and the measurement on inspiration increases week by week over that of expiration. The enlargement is too great to be accounted for by increase of muscular tissue or subcutaneous fat around the chest. In fact the capacity of the lungs increases from 25 to 100 cubic inches by measurement with a spirometer. These changes, remember, take place while the paReactions During Treatment 83 tient is resting. The muscles all over the body increase in size. To one who has had no experience with this treatment, it seems incredible that the muscles should not only rapidly increase in size, but become much harder. Yet it is a positive fact that the voluntary muscles of the body become firm and solid, almost like an athlete’s limbs after a hard course of training. And this, too, while the patient is lying abed all the time, except when attending to the necessary calls of nature, or taking the daily bath. And that bath a warm one, usually considered weakening! People are too apt to compare a patient taking the rest cure with one in the last stages of chronic disease, or bedridden from the weakness accompanying typhoid or other fevers. As a matter of fact the two conditions are entirely different. In the latter case, the patient is compelled to take to his bed because he is ill and weak and unable to take or assimilate nourishment, and the food that is given him does little or no good, and may be really harmful as he has no appetite and lacks the necessary secretions to properly digest food. But the great majority of patients taking the milk cure are “walking cases.” Indeed, many of them demur at the idea of going to bed at first. But go to bed they must to take the milk properly, and after the preliminary fast, they usually have all the necessary appetite and the right condition of the stomach, to take milk easily, and taking the amount usually given, they are assimilating more nourishment than the ordinary person takes, even while doing hard work. But milk is, so far as I know, the only food that can be taken in full84 Milk Diet amount with benefit, while enjoying as perfect rest as may be possible. The hardness of the muscles, on a milk diet, is due largely to the fact that they are pumped full of blood, like all the other organs of the body. And, it is well to recall the fact that the internal organs themselves contain a great system of muscles. Not voluntary muscles, it is true, but muscles that are controlled by the wonderful sympathetic system of nerves; muscles which do their work without any effort or knowledge of the will; muscles that work while we sleep. Without them digestion would be impossible, for every movement of the stomach and intestines and the food products contained in them is due to these muscles. The whole alimentary canal (oesophagus, stomach and intestines), contains in its wall a double layer of these involuntary muscle fibers part of them circling around the organ, and the remainder distributed lengthwise, and through the combined efforts of the fibers, the contents of the canal are mixed with the various digestive juices, and gradually pushed onward until absorption has taken place, and the residue has been expelled. This is what takes place in the healthy individual without any consciousness or assistance on his part. But in the invalid these small but important muscles are thin and weak and unable to do their duty. It is not unreasonable to suppose that they build up and resume their normal functions just as do the external muscles, while a person is on a full milk diet. Indeed, although we cannot see these internal muscles develop, we have plenty of evidence that they do, as for instance, the increased size of the abdomen, the larger capacity for food, the facility with which the unusual amount ofReactions During Treatment 85 fluid and solid matter is handled, and the much larger amount of feces discharged. This increased power of the intestinal muscles, and the restoration of the peristaltic movement, is all that is necessary, in many cases, to overcome constipation. All the muscles, as I stated above, increase in size. I have noted an increase in the thigh of over an inch in a week. The abdomen is always first to show an enlargement, then the thighs and buttocks, although at the same time the neck, shoulders, arms and face are making visible progress. The calves do not make a corresponding gain while the patient is resting, but rapidly assume proper proportions on being called on to support the body in walking. The rapid increase in girth of the abdomen is very significant. It means that the thirty-odd feet of the alimentary canal are being developed. From the condition so often seen at autopsies where persons have died of malnutrition and the intestines are thin and juiceless, perhaps as brown and almost as dry as the casing from a bologna sausage, they are changing to the thick, juicy and normal condition of an infant’s bowels. The circulation of capillary blood vessels and lymphatics in and around the intestines is greatly increased on a milk diet. The fat of milk is in such minute globules that is ready for absorption by the lacteals and from them it is carried almost directly into the venous circulation. The large amount of fluid in milk which must pass through the blood before leaving the body, the greatly increased amount of fat, sugar, nitrogenous matters and salts in the right proportion and condition required for nourishment, stimulate the millions of glands lining the canal and they are compelled to increase in size and capacity.86 Milk Diet This abdominal increase is very largely in the walls of the stomach and intestines at first. Later on there will be more or less fat deposited subcutaneously. Every healthy person has a protecting pad of fatty tissue in front of the intestines and stomach. This intestinal development and enlargement is necessary to insure proper digestion and assimilation, but is occasionally objected to by ladies who note the loss of a wasp-like waist and the necessity for a new wardrobe with regret. They do not, however, object to the increase in the size and symmetry of the limbs and bust, the filling in the hollows in the neck, the smoothing out of the facial wrinkles and the “peaches and cream” complexion that go with it. I am able to offer some comfort by informing them that a portion of the waist development will disappear when they become more active, and another portion will be lost when they quit the milk diet, but with a correct manner of living and sufficient nutritious food the stomach will never return to the previous abnormal condition. During the last few years I have noticed an increasing number of invalids with disorders of the bowels, principally the colon. These people have usually given a history of “catarrh,” or “inflammation of the bowels,” often of constipation, and rarely of diarrhea. Some of them say they are full of acid and rheumatic. In a small percentage of these cases I notice the amount of milk they can take is limited, because an excess brings on diarrhea. They may take three and one-half quarts of full milk daily, but another pint causes a watery, acid diarrhea. This acid diarrhea is often due to lack of pancreatic secretion. Examining the records of 820 recent patients, I findReactions During Treatment 87 that a few days after starting on the milk diet 34 per cent of them were more or less constipated; 8 per cent of them had diarrhea on anything over three and a half quarts of milk daily, and 58 per cent were able to take enough milk to overcome the constipating tendency of the diet. This shows that about one patient of every twelve or thirteen has loose bowels on what is considered a normal amount of milk, or the amount that keeps them from losing weight. In the case of a patient commencing the milk diet and taking about six quarts, should diarrhea occur and continue for more than thirty-six hours, with passages loose, sour or greenish, or containing small undigested curds, it is evident that the bowels are unable to digest all the food. The amount, therefore, must be reduced about one-half until solid movements occur only once or twice daily. Too little milk will cause constipation, and then the amount must be increased. I have seen cases where a variation in the daily amount taken, of two glasses, would make the difference between constipation and diarrhea. When the proper dose is found, these patients receive great and lasting benefits. On less than four quarts, the gain in weight is very small, and this is rather discouraging to some of them, but in every case of this kind where the quantity of milk has been carefully adjusted to the condition of the bowels, the ultimate result has been very satisfactory. Several ladies who were below weight and affected in this way only gained about two pounds a week, while on milk, but on returning to ordinary habits and diet, continued to gain at an even greater rate, and remained free from trouble for which they took the milk cure.88 Milk Diet In severe cases of diarrhea on the milk where patients can only take two or three quarts in 24 hours, I have found that a few dates, taken one at a time, two or three hours apart, and dissolved in the mouth, enable people to take a pint or two more every day. A cracker or two may have the same effect, but I do not approve of them because the same permanent cure does not seem to be obtained as on the exclusive milk diet. In bad cases of chronic dysentery, perhaps due to tubercular infection of the bowels (consumption of the bowels), I have cured several by administering a small cupful of boiled rice and milk, two or three times a day, in place of one of the regular drinks. The rice certainly helps to check the food from passing through too quickly. The skin, including the hair and nails, shows decided reactions in the milk cure. A healthy skin is a rarity nowadays, and the average candidate for the milk cure, with bad digestion, poor circulation, and probably kidney trouble, shows plain evidence of his internal disease by a great variety of skin disorders, ranging from the pale, white, and dry leathery skin, to various forms of eruptions and inflammatory conditions. Remarkable changes take place in this important organ. The capillary circulation grows faster, perhaps, in the skin, than in any other part of the body. The prolonged warm baths greatly assist in this improvement, by softening up the dead cells of the external layers, and by the moisture and warmth penetrating to the deeper layers. The baths alter distribution of blood pressure by increasing vascularization of the skin and temporarily unloading internal organs. The warmth, moisture and water pressure increases oxidation, calmsReactions During Treatment 89 the nervous system, allays reflex instability, and produces sleep. N o matter how cold or dry or flabby or wrinkled the skin may be, between the warm baths externally and the increased amount of blood internally, the skin always seems to get back to a healthy condition. Patients who had not visibly perspired for years, show a perceptible sweat within a few days, and frequently the skin starts up action suddenly, a short time after the patient has gone to sleep in the evening, and he wakes up bathed in perspiration. I have seen such cases where not only the bed linen, but the mattress as well, were so soaked with sweat as to require changing. Such a climax, weakening and discouraging to some invalids on an ordinary diet, has just the opposite effect on the milk diet, because it is the result of increased capillary circulation, and not due to weakness of the blood vessels and thin, watery blood, as in the ordinary “night sweats.” One symptom that many patients speak of while on the milk and resting, is cold feet. Not cold enough to be uncomfortable, but quite noticeable, especially as all the remainder of the body is warm and glowing. I have seen it so many times, even in patients who had never had such a thing before, that it seems quite natural to me. The reason is simple:—The feet are hardly used while in bed and there is no need of the circulation of blood rushing there, as it does to the body generally, and also, the blood stops mostly in the abdomen and vital organs, where it has work to do. Cold feet are noticed more in the afternoon than any other time. Never at night, after milk drinking stops. Just as soon as the patient begins exercising the feet become normally warm.90 Milk Diet If the warm, moist skin be rubbed, soon after starting on the milk diet, one can often notice little black rolls of dirt, dead cells, and waste matter discharged through the sweat glands, and the odor coming from the skin saturates the atmosphere of the room, and will be found excessively strong on opening the bed to air, especially with rheumatic patients. Indeed, the rooms of these patients smell like a vinegar factory for a few days. A rapid increase in body weight occurs to every one below weight taking the full milk diet, no matter what their previous condition or disease. While this is usually welcome, there are certain patients who do not desire it, but they have to accept it, at first anyway, because it is almost impossible to take the cure correctly without gaining in weight. Someone has divided the human race into two classes—those who are too fat, and those who are too thin, and while the milk cure appeals more to the latter class, yet it seems to me that stout people get just as much benefit from it as thin ones, but it is harder to induce them to take it. The gain in weight made by a person who is overweight or about normal, is not as great as that made by a thin or emaciated person. The latter will take on weight rapidly, almost as a sponge soaks up water. Most of them are poorly nourished, whether they are eating much or little, and the milk alone, taken under proper conditions, seems to be just what they need, and they build up all parts of the body very easily. The average gain in weight for thin folks is about five pounds the first week, and after that about half a pound daily. This latter rate continues for weeks, or months, until they are near the normal weight. The greater increase for the first week is, in some measure,Reactions During Treatment 91 due to the fact that they have had more or less of a fast before commencing the diet, and are consequently almost empty, and in a good condition to assimilate nearly all of the milk. A gain of fourteen pounds the first seven days has been made under my observation, and a young man gained ten and a quarter pounds in his first three days, but his was a very exceptional case, as his stomach had been in such a wretched state that he had been unable to retain even the simplest food, previous to taking the treatment. I started by giving him small and frequent doses of carefully warmed milk, while he was resting completely, in bed. Beyond a very slight pain in the stomach at first, he had no discomfort at any time, and rapidly regained his health. I am often asked if the average rapid gain of flesh is not too great to form healthy tissues, and even if it may not be unsafe. I say, emphatically, that all this increased weight is made of healthy tissues and that there is absolutely no danger while taking complete rest. There are certain preparations advertised, by the use of which, it is claimed, rapid gain is made in weight, while eating ordinary foods. I have seen very injurious effects from the use of some of these drugs, and I regard such methods as wholly unnatural. The flesh gained is probably largely fat, and the digestive organs, instead of being built up and fitted for normal digestion, are worse off than before taking the medicine. The gain made on milk diet, while resting, is not principally fat, as some people imagine. An increase of an inch a week in an emaciated person’s thigh, between the knee and the hip, cannot be called fat. There is very little fat in this part at any time, but there is an enor92 Milk Diet mous group of muscles and it is the growth of these muscles that produces the enlargement. The muscles increase because they are distended with blood. The inunction of fat, or so-called flesh foods, or “oil rubs,” cannot produce any permanent benefit and may cause considerable harm. The massage may temporarily stimulate the circulation, but it would be better to practice it without the oil. Only a few cases lose weight in the first week, while taking the amount of milk I prescribe. Some of these suffer from valvular disease of the heart, and after the initial loss go on as usual, gaining weight and health. One case had been the subject of severe surgical operations and lost several pounds at first, but then gained at a fairly satisfactory rate. Patients having dropsy are almost certain to lose weight at first. Sometimes the dropsy may be unsuspected, as in the abdomen, or around the heart, but when the quantity of urine voided exceeds the quantity of milk taken, the evidence of internal dropsy is clear. I have known a patient to pass 12 quarts of urine in 24 hours, while only taking 13 pints, or only about half as much milk. Nothing can equal milk in curing dropsy. Two gentlemen suffering from diabetes lost weight on the milk diet (six quarts) for a few days and both quit the treatment, but seemed to have derived some benefit from the short course. Since writing the above, another advanced case of diabetes tried the exclusive milk diet for a week, and then refused to go on with it as he was losing weight and becoming much weaker. I advised him to use all the buttermilk that he could assimilate, and have sinceReactions During Treatment 93 heard that he had made a wonderful improvement. (See article on Diabetes in Chapter XII.) In discontinuing the diet, undoubtedly the best way to resume ordinary food is to stop the drinking of milk at noon and eat a very light supper the first day. A slightly cooked yolk of egg, bread and butter, salad or fruit, is enough. The next day start with the milk as early as usual, again stop at noon, and eat a somewhat heartier meal in the evening, if the appetite calls for it. Another meal that may be taken the first day is well cooked cornmeal mush and milk. Patients can eat all they desire, but nothing else may be taken with it. I have never known this “first meal” to disagree with anyone. Always have some uncooked foods with your meal; salads, fruits, nuts, cheese, raw egg yolks served in various ways, olives and olive oil, or peanut oil, etc. A diet of two or three quarts of milk, taken in forenoon and an evening meal, can be used as long as desired. If cream has risen on the milk, remove it. Do not attempt to mix cream with milk, when drinking milk alone. A breakfast of milk, not over a quart, with an apple, and two meals a day, will enable anyone to hold their weight, if proper combinations of foods are made. Always remember this: Never stuff on ordinary foods. Milk is the only thing that can be used safely for forced feeding, and it must be taken alone, or, in most cases, fruit can also be used. After taking the milk cure, all patients who previously suffered from dyspepsia, and particularly, nervous dyspepsia, must use care on resuming solid food. It is necessary to have a simple diet, to eat very lightly, and to observe regular hours for meals, never eating anything between meals, until the stomach be94 Milk Diet comes used to the change. If constipation returns, after a course of milk diet, it is almost a certain sign of overeating. I have noticed in a few cases that some distress has occurred during the first few days after resuming solid food, but this symptom has soon disappeared as the organs became used to the diet. Usually there is not as much trouble in changing from milk to solids, as in changing from the usual food to the milk.CHAPTER VI. DYSPEPSIA. PROBABLY the simplest trouble that may be cured by the milk is dyspepsia or indigestion. Usually brought on by an incorrect way of living, when the condition is relieved and the patient instructed how to avoid a return of the disorder, there is no good reason why he should suffer from it again. When you tell people that they are not eating right, they may say they eat the same as other members of the family who are apparently having no trouble. Now, it is a fact that there are no two people with stomachs just alike. Among thousands of cases who have taken the milk diet under my observation, I do not remember any two who acted, or reacted just the same. With a score of patients taking the milk diet at the same time, with all conditions as to amount of milk, time and manner of taking just the same; all resting in bed, all bathing daily, everything just the same, as nearly as may be, yet no two will have the same symptoms. With some the bowels are constipated; others have a diarrhea, some have regular movements. Most people have a chalky white color to the stools at first; some start off with a normal yellow color. Some of these with white stools will suddenly change to a deeper tint, as the fiver starts up; others make the change very gradually. Some patients complain of a bad taste in the mouth; others never have it. More of them have a heavy coating on the tongue, at first brownish or yellow, later white; others manage to keep their tongues clean. Great variety is observed as to the way the milk tastes. Most pa-96 Milk Diet tients seem to have a relish for it, in greater or less degree; a few declare it is like taking medicine and they only take it for the effect. Some will say it tastes very sweet, like sugar; others that it has a bitter or sour taste. Precisely the same milk, mind you. The disagreeable taste may disappear at any time, and perhaps not return. Some who do not have free evacuations of the bowels will say the milk gets “flat” toward evening. If given an enema, the proper taste of the milk soon returns. Many patients taking the cure have said they would never want any more milk after they had finished their course. Doubtless they felt that way while they were “stuffing” it, or taking more than the stomach called for, or wanted, but nevertheless I believe it to be a fact that no patient has permanently lost their liking for milk through taking it as I recommended. After commencing on solid foods, only a short time elapses before they miss the milk, crave some, if only a glass a day. It frequently happens that people take the treatment who do not like milk, and in some cases they have not used it, in any way, for many years, forty and fifty years, respectively, in two cases that I recall. With one single exception, all these people have used milk freely afterward and would not like to be without it. Milk that has been incorrectly handled may have an appreciable odor that is disagreeable to sensitive patients. This odor can be entirely removed by pouring the milk through a sieve, or strainer, containing freshly cooked popcorn. If the popcorn is ground up in a coffee mill it will work even better. It is very seldom that patients become hungry on the milk diet, and where they do, it probably is because they are not taking their milk regularly. But there haveDyspepsia 97 been cases who felt like eating most of the time during the first two weeks. In these rare cases the craving has been generally for some special article of diet, as bread, or some kind of vegetable or fruit. I have never known anyone to desire meat, except perhaps bacon. Thirst is a very rare symptom while on the milk diet, and I do not remember any patients in New York who took water in addition to their milk, but in California I have seen several such cases, perhaps due to the drier atmosphere. There is probably no reason why water should not be taken during the treatment, but I hardly see the need of it, as most patients get over five quarts of water in their milk daily. It is not uncommon for those taking the milk to wish for something sour, and particularly sour fruit, apples, oranges and even lemons. Lemons can be used beneficially by those who suffer from nausea while commencing the milk diet. Others prefer the sweet fruits, figs, peaches, grapes and melons. Nearly everyone relishes dried fruits, like raisins, figs, dates, prunes and apricots, and all these are frequently useful in overcoming the initial constipation. Sliced tomatoes with lemon juice and salt are a most useful addition to the milk diet of the constipated. Canned tomatoes have also been used. In the matter of sleep patients vary widely; some want to sleep all the time, while others only sleep a few hours at night. Cases of insomnia sometimes notice no improvement for several nights, and then, all at once, they begin to sleep like children. I have taken considerable space to explain how the milk diet affects different people, while speaking of dyspepsia, because nearly every disease is accompanied by more or less stomach trouble, although the symptoms are quite varied.Milk Diet Indigestion is almost a national disease with Americans, and in very many cases it is due to over eating and imperfect breathing, or lack of exercise. There is not much use of my wasting the reader’s time in giving advice as to the amount of food they should eat, or what kinds they must avoid and what they may eat, and how long they should chew it, and how many meals they should take, because all dyspeptics have had plenty of such advice, without being cured, but I will, later on, give some directions to be followed after putting the stomach in good order by the milk diet. I firmly believe that defective breathing is more of a cause of dyspepsia than over-feeding. Few people realize how important breathing is to health. We breathe mainly to absorb oxygen. The function of oxygen is to combine with the food we eat, and if sufficient orygen is not taken into the system to oxidize the food, indigestion results. Food is taken into the body just as fuel is taken into a furnace, for the same purpose—to be burned up, and burning always means oxidation. A lamp or a stove cannot burn without a plentiful supply of oxygen, nor can the human body perform its functions more than a minute or two without air. Oxygen should really be considered a food, for none of the regular foods would be of any use in the body unless they combined with oxygen. Animal life is an incessant process of combustion; it may also be said that life is combustion. Oxygen is the great supporter of combustion, although not combustible itself, hence the fires of life burn with increased brightness when oxygen is plentifully supplied. Cold air, if pure, is one of the most powerful aids in eliminating those poisonous substances that are perpetuallyDyspepsia 99 forming in the human body as the result of the digestive process. Oxygen possesses an affinity for nearly every other element with which it forms compounds, innocuous in themselves or susceptible of easy elimination. The oft-quoted term, “oxygen is life,” is not so much a misnomer as some might imagine, in view of the important part it plays in Nature. It is impossible to place too great a value on cold, fresh air. Experience has shown that nearly all patients suffering from various diseases of the lungs have recovered in the open air cure. The indifference, not to say aversion, that many people display to fresh air, especially in their sleeping apartments, would be ludicrous if it were not pitiable. Yet it is a fact that any person would be warmer in a bedroom through which a current of cold air was passing (provided they were well covered), than they would be in a heated room, illy ventilated, for no warmth can equal that produced by active combustion. Some people never breathe right; many people work and sleep in places where the air is bad, and, while it is possible for either class to enjoy fairly good health, if the defective breathers have to breathe the bad air, the result is always ill health. A man may work every day in a place where the air is impure and lacking in oxygen, and yet, if his work calls for vigorous exercise, and therefore copious breathing, he may appear to be in the best of health. But let the shallow breather work in the same place, at some sedentary occupation, and before long his health fails, he becomes pale-faced, anemic, has less strength, less endurance. His desire for food decreases, and what he does take is not thoroughly digested, hence he has less blood, and that of a poorer quality. Perhaps, realizing that his stomach is not performing its functions100 Milk Diet properly, he assists it with some digestive medicine, or he takes foods that are recommended to him because they are predigested. In either case he may notice an apparent improvement, but in either case he has further weakened his stomach by usurping its natural functions, and if the primary cause of the trouble is not remedied, his temporary expedients will soon fail to have even an apparent or transient effect. I want to make this point clear: We cannot habitually perform for the body any of its functions that should naturally be performed unaided, without weakening the part concerned. We cannot use massage or kneading of the bowels for any length of time to produce defecation, without weakening the natural peristalic movement of the intestines; nor can we use cathartic medicines long without the same result. The stomach should digest our food, and we cannot live on predigested foods long, without weakening those glands which normally secrete the digestive juices. We certainly cannot add pepsin to our food before we eat it, without taking away the function of the peptic glands, and, while they may have been secreting too little pepsin before, they are likely to produce still less when the food comes into the stomach already peptonized. The simple act of cooking, which is one kind of predigestion, may, in some cases, be a contributory cause of weak digestion. Our digestive apparatus was originally designed to work on uncooked foods, for fire was a later invention, and all animals at the present time, except man, use by preference uncooked foods. We are too much inclined in the hurry and worry of modern life to eat those things that may be swallowedDyspepsia 101 and digested quickly, without regard to the ultimate effect on the stomach. Professor Einhorn says: “The diet in health should not always comprise the most easily digestible substances. For by so doing we weaken our digestive system.” Stomachs can be spoiled by giving them too little to do, and they must be able to digest much that is difficult of digestion, as well as that which is easily digested. But aside from the fact that the stomach must be able to take care of such foods as come to it on an ordinary diet, the great question remains, are these predigested foods able to make as good blood as natural foods do ? It is a fact that the great majority of patients applying for relief from digestive troubles are in the habit of using foods designed to save the stomach some of its natural work. A story I hear very often runs about this way: “Some time ago my health began to fail; my stomach was bad, and the only thing I could eat with comfort was Somebody’s breakfast food (or Dr. So-and-So’s prepared food, or some grain combination claiming to be predigested and all ready to eat). But while this food caused no distress I have been getting weaker and cannot touch the ordinary food that my family eat.” And these people always lay stress on the statement that they have been very careful of their stomachs! Most of these prepared cereal foods are steamed or boiled into a mush, with various ingredients like salt, glucose, molasses, or malt, added. Then they are usually either made into a dough and baked, and ground up into crumbs, or rolled into flakes and parched. After being sealed up more or less tightly in pasteboard boxes, they102 Milk Diet are ready for sale. When finally the retail dealer gets such foods, they may lie on the grocery shelves for months before being sold. Every country store is stacked to the ceiling with preparations of this kind, for which an artificial demand was created by enormous advertising, but when the advertising stops, so does the demand. The manufacturers of many of these products who have become rich by buying cheap cereals, or grains that have already been used in making malt liquors, and selfing them for ten times their cost, employ high-salaried advertisement writers, who dilate on the cleanliness and thoroughness with which the goods are handled and cooked, but I do not believe that stuff prepared in this manner can be of much service in the human stomach, and even animals refuse it unless they are very hungry. I do not include in this class foods composed of the germ of wheat, which is not cooked, nor sterilized by any chemical method, nor the rolled preparations of wheat, oats and rye. The latter are steamed for some time and while still wet are run between rollers and pressed into thin flakes. After drying the product is ready for marketing. Such rolled grains do not pretend to be more than partly cooked and are supposed to be thoroughly recooked before serving. Grain prepared in this manner does not lose all of its vitality, or blood-making power. Some grocers raise the objection that such foods do not keep for long periods, like the ready-to-eat, sterilized brands, as they are apt to be attacked by weevils and other insects. This, in my opinion, is a pretty good test of the food quality of an article. Insects, with their magnified sense of sight, smell and taste, are better judges of the food value of an article thanDyspepsia 103 human beings. As an example, I have known ants to find an opened package of Germea on a pantry shelf, and when discovered, the wise little animals had a line many yards long between the cereal and their nest. Each ant returning to the nest carried a little particle of the food, doubtless for the nourishment of the home colony. An instructive feature of the incident was the fact that the ants, to get at the preferred article, had to climb over several opened packages of other foods, each of which was guaranteed by the manufacturer to be all ready to eat. Grant’s Hygienic Crackers, made in California, are an excellent food for dyspeptics. They consist of a palatable combination of grain, well baked, and are rather hard, requiring some beneficial effort of the jaws, in chewing. The cause of much indigestion, particularly of starchy foods, is deficient secretion of pancreatic fluid. Digestion of starchy foods is either performed by the action of the saliva, in the mouth and oesophagus, or after passing through the stomach, by the juice secreted by the pancreas. The stomach itself has no action on starch. The pancreas is very often at fault in people of sedentary habits, and if such people do not very thoroughly chew their bread, potatoes, etc., and thereby largely digest the starch before it is swallowed, it passes through the stomach unchanged and is very apt to ferment in the intestine. Persons with this trouble can often live in comfort on meat, yolks of eggs, fruits, buttermilk and non-starchy vegetables, but bread, for them, is by no means the staff of life.104 Milk Diet The secretion of a healthy pancreas, which is discharged into the small intestine, amounts to about a pint in twenty-four hours. This amount may be greatly reduced, in ill health, through inactivity of the gland. Total absence of the juice from disease or removal of the gland, results fatally. The pancreatice juice is of great importance in the digestion of milk, and on a milk diet, the gland becomes very active, and presumably returns to a healthy condition, for, on resuming a normal diet, patients do not suffer from starchy indigestion and fermentation. Other forms of indigestion, or inability to digest certain foods, as berries or acid fruits, nuls, and certain vegetables, like cabbage, are always completely cured by this treatment. To sum the matter up in a few words, it puts the stomach in a normal, healthy condition.CHAPTER VII. CONSTIPATION. CONSTIPATION is a very frequent accompaniment of digestive disturbances, and while it is usually only a symptom in itself, and disappears as the trouble which caused it is cured, it deserves separate consideration. It is my impression that a great deal of constipation, or irregularity of the stools, is due to the fact that many people do not know how to attend to the important function of defecation. They either do not understand it, or they wilfully neglect it. A little study of the parts involved, and their physiological action will be interesting and instructive. Food, after passing through the small intestine rather rapidly, enters the colon, or large intestine, as a liquid, or of a liquid consistency. The fluid is largely absorbed during the slower passage through the large intestine, leaving a residue of feces to be discharged from the rectum. The large intestine is about five feet long, including the rectum, which comprises the last eight inches. The rectum, like the rest of the intestinal canal, has involuntary muscles in its walls, running both longitudinally and circularly. The circular muscular fibers near the outlet are increased in thickness and form a well defined ring, about one inch wide, called the internal sphincter muscle. Just beyond this, but entirely separate from it, is the external sphincter, of voluntary fibers, which ordinarily keeps the anus closed. Now notice the different kind of muscles composing106 Milk Diet the internal and external sphincters. The external sphincter is a sort of purse-string muscle, under control of the will, which keeps the outlet closed except when we wish to discharge the contents of the rectum. The internal sphincter is, like all the rest of the muscular fibers in the intestinal wall, an involuntary muscle, and we cannot directly compel it to open or shut by will power, no matter how much we may desire it. The contents of the intestinal canal are propelled onward by peristaltic, or worm-like movements, which are entirely involuntary. These movements are caused by wave-like contractions of the muscles in the walls of the tubes, each part of the tube as the wave reaches it, narrowing its caliber, and then gradually relaxing and dilating. This wave of contraction is gentle, and progresses slowly from above downward. The advancing wave is always preceded by a wave of relaxation, or inhibition. When we inhibit or relax the tension of the muscular fibers in any circular organ, as intestine or blood vessel, the organ naturally dilates and the space in its center becomes larger. As the contents of the large intestine arrive at the rectum they are composed of undigested and indigestible matter, about 75 per cent of water, and considerable waste matter, including cast-off cells, inorganic salts, putrid products, and bacteria. When a sufficient quantity of feces has arrived in the rectum there is felt a need of expelling it. This sensation varies greatly, according to the amount of matter present, and the susceptibilty of the individual, but principally owing to the nature of the discharge. If the matter is rather solid, and of a non-irritating nature, it may be retained in the rectum for hours, or even days, while if it be watery or acid, as in diarrhea, the strongest effort of the will is sometimesConstipation 107 insufficient to keep the external sphincter closed and prevent a passage of the contents. The act of defecation is normally an involuntary one, as may be seen in infants and animals on a natural diet. In most adults it becomes partly voluntary, owing to a variety of causes, such as the habit of preventing the stool until a convenient time, and to unhygienic habits in general. The voluntary part is, however, smaller than generally supposed, consisting mainly in the relaxation of the outlet, and the compression of the abdominal contents by holding the breath and contracting the diaphragm and abdominal muscles. The compression of the abdomen, or straining, practiced by many persons, and particularly constipated people, usually does more harm than good. It has no effect on matter in the lower part of the rectum, as Professor Foster says in his Textbook of Physiology: “A body introduced per annum into the empty rectum is not affected by even forcible contractions of the abdominal walls.” If the peristaltic movement is not operating in the rectum, and the internal sphincter is not properly relaxed, we should not try to have a movement. If under these unfavorable circumstances, after long straining, we do succeed in our object, what happens is about as follows: We have so compressed the abdominal portion of the large intestine that its contents, perhaps unready for the movement, are squeezed downward, while the absorption of the fluid portion is unnaturally hastened, and matter thrown in the blood that should have been further elaborated in the bowel, or discharged with the feces. Although a passage may sometimes be affected by such unnatural straining, its results, both immediate108 Milk Diet and remote, are bad. The immediate effect includes the disarrangement of the digestive processes, not only in the large intestine, but in the small as well, and probably other abdominal organs, in the forcible pushing into the blood and lymphatic circulations of unsuitable substances, causing headaches and auto-intoxication, while the after consequences are that the constipated habit is more firmly fixed, the next stool almost certainly being dry and hard, and the natural mechanism of defecation more weakened and less inclined to perform its duty. Piles, or hemorrhoids, are probably always caused by straining at stool, as the pressure prevents the venous blood returning to the heart and it accumulates in the mucous membrane of the rectum and distends it until tissue gives way and a blood tumor, or pile, results. The contents of the bowel act in different ways to produce a normal stool. By irritating the mucous membrane, nervous centers are excited which cause a reflex peristaltic movement of the intestinal muscles, and by the secretion, or production of osmotic conditions, which cause fluid to flow into the cavity of the intestine, until it becomes so watery that it may be discharged. Various laxative foods act directly on the arrival of their undigested portions at the rectum, as the coarse fibers of cereal coverings, small seeds of fruit, or indigestible skins of tomatoes, prunes, etc., or they may act immediately through the circulation, as it is not uncommon for people to have to go to stool within a short time after eating the first peach, or pear of the season, or any fruit that is unusually well relished. And some people say that eating any article which causes a copious flow of saliva will bring on a movement. A small amount of laxative fruit usually acts better than too large a quantity. Some doctors advise the eating of just one fig atConstipation 109 bedtime, or one apple before breakfast, knowing that eating a larger amount, or perhaps overeating, seems to have frequently the opposite of a laxative effect. Overeating of any food or foods is a prolific source of constipation. The habit so many people have of sleeping on the right side may be a cause of constipation. It is a fact that many constipated persons make a regular practice of sleeping on the right side, to make it easier for the heart, as they think, but it places the principal portion of| the colon in such a position that the contents have to go straight up, against the force of gravitation. An excellent plan for such cases is to sleep with the back up, with the face turned to one side, say the left, with right arm down by the side. Anyone can do this with a little practice. While constipation is an unsanitary habit, to say the least, it is nevertheless a fact that many people who have it magnify the condition and its dangers. There are many such persons, whose one object in life seems to be to have a daily movement, whether there is anything to be moved or not, and they are in misery unless they have it. And, after having it, by force, if necessary, they are not happy, because they immediately begin to plan for the next day. Everything they eat or drink is judged by the test: Is it constipating or not? They stuff themselves with unsuitable foods, because someone declares them laxative, and they decline really nutritious articles, because they have a reputation for causing costiveness. Their drinks, also, have to pass the same test, and healthful fluids are rejected, perhaps, in favor of some foul smelling and tasting mineral water, because the latter moves their bowels, disregarding the fact that these waters are often artificially impregnated with salts110 Milk Diet by the manufacturers and may contain many impurities. It is but a step from them to out-and-out cathartic medicines, and then, usually, all chance of restoring the normal movements of the bowels is gone, except by radical action. A simple and good cure for many of these cases, which I have often successfully applied, where the people had common sense and will power enough to carry it out, is to have them eat, in moderation, anything they relish, chewing it well, and instead of trying to have a movement of the bowels, try hard not to have one. Instead of yielding to the first faint hint that the bowels might move, restrain it, until the next day, or two or three days, if necessary. Retain even the gas, if any is inclined to pass, and, my word for it, there will come a time when an impulse will be felt about which there can be no mistake, and a satisfactory evacuation will result, without straining or forcing into the circulation a lot of stuff which does not belong there. Don’t try to force out every particle that you think may be in the rectum, but keep some for next time, so to speak, and the next time will also be easy, and the next time after that, and all the other times. This plan will not suit the manufacturers of expensive machines intended to wash all the food out of the colon, by using large hot-water injections. They may claim that you will get ptomaine poisoning, or auto-intoxication, but such things, in my experience, have usually been caused by bad food, imperfectly digested, forced out of the colon into the body against the wishes of the absorptive cells, which could not stand the pressure put on them. As to the use of injections, I will say here, that occasions may arise when they are temporarily of great use, but as a means of curing constipation, it is irrational toConstipation 111 distend the bowel, already weakened and dilated, with large enemas of warm, or hot water, and the most difficult cases to cure are those where the colon and rectum are paralyzed from long use of such measures. There would be very little constipation with anyone if the internal sphincter relaxed readily and the peristaltic movements were active. When contracted the sphincter acts very much like a valve or gate, opening inwardly, and the more pressure we put on it the tighter it shuts. Just why it does not open, or relax, when we wish it to, is a difficult question to answer. It cannot be relaxed by simply willing it to as we would relax the muscles of the arm, for it is not a voluntary muscle. Some people, who are always on a nervous tension, put so much extra force on the external sphincter all the time that it gets in a state of continuous or tonic contraction, and communicates its rigidity to the internal muscle sympathetically. Such people may suddenly decide that it is time to have a movement, and they relax the outer muscle, and attempt, by pressure, to overcome the resistance of the inner muscle. But this is not the right way to go at it. A better way is outlined above; simply wait until the desire is irresistible then the inner sphincter is sure to be relaxed and the peristaltic movement sufficient to move the contents out without using abdominal pressure. Another, and perhaps opposite method of securing the desired result is to obtain a general relaxation of the body, which will secondarily or sympathetically affect the involuntary muscles. This is explained in another part, under the title of Rest. A method frequently advised is the use of massage112 Milk Diet over the abdomen, by manipulation with the hands, or rolling a cannon ball over the location of the colon, or bringing the abdomen forcibly against some object, as a strap between two posts. All these are unnatural procedures, and while possibly useful temporarily, in some cases, they never tend to produce a cure, but instead, further weaken the intestinal muscles by usurping their functions. As contrasted with passive exercise, active exercise is far better. Exercise of any part of the body makes deeper breathing necessary, and that means more up and down action of the diaphragm, which in turn produces more movements of the abdominal contents. More oxygen enters the blood, and more blood circulates through the vessels, everywhere, stimulating all the muscles. This induces warmth, and perspiration, and when there is external perspiration, there is usually a watery excretion through the mucous membrane of the intestines as well, for the inner lining of the intestines is really outside of the body proper, in the same way that the skin is. Not only does proper exercise bring into use the external muscles of the abdomen, whose action is readily apparent, but also important muscles lining the abdominal cavity, connecting the backbone and pelvis and thighs, the movements of which must have a considerable influence on the abdominal viscera. There can be no question about the benefits of exercise to the constipated, it is a necessity. Movements particularly useful in these cases will be explained under Exercise. Directions in regard to diet will be given in the chapter entitled After Treatment. The reader will note that, so far, in treating of constipation, I am speaking of persons in ordinary circumstances, and not those on the milk diet, or resting.Constipation 113 What does the milk diet do for people afflicted with constipation? It is the only perfect and natural cure that I know of. On no other diet can the bowels be restored to their natural functions, while the patient remains in bed, resting. On no other possible diet can anyone build up the entire muscular system of the body, both voluntary and involuntary, while taking complete rest. On no other diet is it possible for one to gain healthy flesh rapidly, without exercising, or submitting to massage. Most people find that drinking fresh milk with other food increases the tendency to constipation. E)ven when they attempt an exclusive milk diet, using a few pints daily, the trouble is increased. A few people of this class say that milk acts as a laxative to them. The use of buttermilk, sour milk, and sour milk cheese, tends to prevent constipation in nearly every case. It is impossible to use anything but fresh milk in the milk cure, because that is the only substance that the stomach can take continuously, for unlimited periods, without tiring of or rejecting. However, it is often useful to give a glass or two of buttermilk, or some cottage cheese (made without scalding) if the bowels do not move naturally while taking the full amount of milk. Sour milk that has coagulated, called “clabber, or loppered milk,” may be beaten up with an egg beater, and makes a very good substitute for buttermilk. But the best of all ways of overcoming the initial constipation on a milk diet is to take more milk. In every case there is necessarily a considerable portion of the milk undigested at first, and the percentage of undigested matter increases as we increase the amount114 Milk Diet taken. On a generous milk diet regular stools occur largely as a mechanical result at first; the accumulated feces are too great in amount to be retained. This is often noticed where patients are taking an amount of milk somewhat too small to cause daily movements. Increasing the amount one or two pints daily generally has an immediate effect, changing the discharge from dry, hard, round balls to a soft, continuous cylinder, with more frequent movements. It is possible that only a small portion of the additional milk is digested, although an increased rate of gain in weight is always shown in such cases. While it is true that certain parts of the milk, as the fat and casein, or cheese, are never entirely digested, there are other parts, as albumen, milk sugar, and mineral salts, that are always completely assimilated. The cells lining the alimentary canal have a selective action; they take out what is needed, and reject the remainder and, under the natural conditions surrounding the milk cure, it is always better to provide too much food than too little, in order to be sure of getting enough of the absolutely necessary materials. Where only one kind of food is taken, it is a simple matter for the digestive apparatus to select from it the needed ingredients, and pass on the residue. The dream of theorists that some day we may be able to supply all the needs of the body by meals of a daily pill and a swallow of liquid, and not have any undigested residue to bother with, will never