When used as an exclusive diet, skimmed milk gives rise to certain very interesting and what I might call normal symptoms. Since at first we can rarely give enough to sustain the functions, for several days the patient is apt to lose weight, which is another reason why exercise is in such cases undesirable. This loss soon ceases, and in the end there is usually a gain, while in most rest cases an exclusive milk diet may be dispensed with after a week. Where milk is taken alone for weeks or months, it is common enough to observe a large increase in bodily weight. 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.

During the first week or two, exclusive milk diet gives rise to a marked sense of sleepiness. It causes nearly always, and even for weeks of its use, a white and thick fur on the tongue, and often for a time an unpleasant sweetish taste in the early morning, neither of which need be regarded. Intense constipation and yellowish stools of a peculiar odor are usual. Of the former I shall speak in connection with the use of milk in special cases. The influence of milk on the urinary secretion is more remarkable, and has not been as yet fully studied.

There is, of course, a large flow of urine; and in dropsical cases due to renal maladies this may exceed the ingested fluid and carry away very rapidly the dropsical accumulations. It is sometimes annoying to nervous persons because of the frequent micturition it makes necessary. I have discovered that while skimmed milk alone is being taken, uric acid usually disappears almost entirely from the urine, so that it is difficult to discover even a trace of this substance; nor does it seem to return so long as nothing but creamless milk is used. Almost any large addition of other food, but especially of meat, enables us to find it again. Creatine and creatinine also seem to lessen in amount, but of the extent of this change I am not as yet fully informed.

A yet more singular alteration occurs as to the pigments. If after a fortnight or less of exclusive milk diet we fill with the urine a long test-tube, and, placing it beside a similar tube of the ordinary urine of an adult, look down into the two tubes, we shall observe that the milk urine has a singular greenish tint, which once seen cannot again be mistaken. If we put some of this urine in a test-tube carefully upon hot nitric acid, there is noticed none of the usual brown hue of oxidized pigment at the plane of contact. In fact, it is often difficult to see where the two fluids meet.

The precise nature of this greenish-yellow pigment has not, I believe, been made out; but it seems clear that during a diet of milk the ordinary pigments of the urine disappear or are singularly modified. A single meal of meat will at once cause their return for a time.

These results have been carefully re-examined at my request by Dr. Marshall in the Laboratory of the University of Pennsylvania, and his results and my own have been found to accord; while he has also discovered that during the use of milk the substances which give rise to the ordinary fæcal odors disappear, and are replaced by others the nature of which is not as yet fully comprehended. The changes I have here pointed out are remarkable indications of the vast alterations in assimilation and in the destruction of tissues which seem to take place under the influence of this peculiar diet. Some of them may account for its undoubted value in lithæmic or gouty states; but, at all events, they point to the need for a more exhaustive study both of this and of other methods of exclusive diet.

As regards milk, enough has here been said to act as a guide in its practical use in the class of cases with which we are now concerned; but I may add that it is sometimes useful, as the case progresses, to employ in place of milk, or with it, some one of the various "children's foods," such as Nestle's food, or malted milk.

Before dealing with the treatment of the anæmic and feeble and more or less wasted invalids who require treatment by rest and its concomitant aids, I desire to say a few words as to the use of rest, milk dietetics, and massage in people who are merely cumbrously loaded with adipose tissues, and also in the very small class of anæmic women who are excessively fat and may or may not be hysterical, but are apt to be feeble and otherwise wretched.

Karell has pointed out that on creamless milk diet fat people lose flesh; and this is true; so that sometimes this mode of lessening weight succeeds very well. But it does not always answer, because, as in Banting, loss of weight is apt to be accompanied with loss of strength, so that in some cases the results are disastrous, or at least alarming. I do not know that this is ever the case if the directions of Mr. Harvey are followed with care and the weight very deliberately lessened. But for this few people have the patience; and, even if they can be induced to follow out a strict diet, it is often useful to be able to cut off very rapidly a large amount of weight, and so shorten the period of strict regimen, or at least put over-fat persons in a condition to exercise with a freedom which had become difficult, and thus to provide them with a healthful means of preventing an accumulation of adipose matter.

This can be done rapidly and with safety by the following means. The person whose weight we decide to lessen is placed on skimmed milk alone, with the usual precautions; or at once we give skimmed milk with the usual food, and in a week put aside all other diet save milk and all other fluids. When we find what quantity of milk will sustain the weight, we diminish the amount by degrees until the patient is losing a half-pound of weight each day, or less or more, as seems to be well borne. Meanwhile, during the first week or two rest in bed is enjoined, and later for a varying period rest in bed or on a lounge is insisted upon, while at the same time massage is used once or twice a day, and later in the case Swedish movements. At the same time, the pulse and weight are observed with care, so that if there be too rapid loss, or any sign of feebleness, the diet may be increased. In many such cases I allow daily a moderate amount of beef- or chicken- or oyster-soup, - more as a relief to the unpleasantness of a milk diet than for any other reason.

Tags: Diets and Weight Loss

About the Author

Silas Weir Mitchell was an American physician and writer. He studied at the University of Pennsylvania in that city, and received the degree of M.D. at Jefferson Medical College in 1850. During the Civil War he had charge of nervous injuries and maladies at Turners Lane Hospital, Philadelphia, and at the close of the war became a specialist in neurology.