Lactose

“ I have often given salol-coated pills containing 1 grain of ipecac and 1⁄6 grain of calomel every two hours to cases of bacillary dysentery with apparent benefit.
For the diet of cases of acute bacillary dysentery albumin water or barley water sweetened with lactose is to be preferred to milk, which is usually not well borne by such patients. Kendall has noted the value of sugar of milk in lessening the toxicity of various organisms. Tea sweetened with lactose is usually well borne. Meat juice expressed from a piece of lightly broiled steak is good. ”

“ Certain forms of carbohydrates are more susceptible to bacterial fermentation than others. Herter claims that sucrose and glucose are much more so than lactose, maltose, or starch. The substances thus formed through bacterial activity are not believed to be toxic in character, but merely irritating. However, the irritation arising from excessive fermentation in the stomach may lead to gastric disturbances of a more or less serious nature; hence the amount of carbohydrate taken under certain conditions must be adjusted carefully. ”

“ The cream of the milk, as well as the lactose or sugar, builds up the fatty tissues of the body as well as helps provide the energy for crying, nursing, kicking, etc. The proteins (the curd of the milk) are exceedingly important; they are especially devoted to building up the cells and tissues of the body of the growing child. ”

“ Lactose, or milk-sugar, is sometimes present in the urine of nursing women and in that of women who have recently miscarried. It is of interest chiefly because it may be mistaken for glucose. It reduces copper, but does not ferment with yeast. In strong solution it can form crystals with phenylhydrazin, but is extremely unlikely to do so when the test is applied directly to the urine.
3. Acetone Bodies.—This is a group of closely related substances—acetone, diacetic acid, and beta-oxybutyric [p. 83] acid. ”

“ Nothing so quickly relieves such sleeplessness, caused by a “sour stomach,” as allowing ten or fifteen grains of ordinary cooking-soda to slowly dissolve in the mouth and swallowing the saliva rendered alkaline in this way.
Milk.—Milk may be looked upon as an ideal food, it being composed of water carrying in solution the three great natural foods—albumins in the form of casein, carbohydrates as milk-sugar or lactose, and fat. ”

“ When vomiting ceases, and solid food can be taken, the feeding is begun very carefully with small quantities of carbohydrates. Lactose is added where possible to any fluid taken. Frequent small meals are then instituted—six between 7 a.m. and 10.30 p.m., thus reducing to the smallest space of time the period of starvation during the twenty-four hours. Protein may be added to the diet when nausea is under control, but fat should be left out for some time. ”

“ Maltose, isomaltose, gentiobiose, and cellobiose, are all glucose-glucosides, the difference between them being undoubtedly due to linkage being between different alcoholic groups in the glucose molecules.
The disaccharide lactose is a glucose-galactoside. It is the sugar which is present in the milk of all mammals. It has never been found in plants. Melibiose, which is the corresponding vegetable glucose-galactoside, may be obtained by the partial hydrolysis of the trisaccharide raffinose (see below) . It is a reducing sugar; forms a characteristic osazone; and exhibits mutarotation. ”

“ S. Ludwigii did not respond to the cultivation in hydrolysed lactose, but, as Slator points out, it is quite possible that repeated cultivation in this medium might effect the change, and this would be strictly analogous to the results obtained with bacteria. Slator's results have been confirmed by Harden and Norris, R. V. [1910] , and by Euler and Johansson [1912, 2] who have made an exceedingly interesting study of the progress of the adaptation. As in the case of mannose the rates of fermentation of glucose and galactose are differently affected by agents such as heat and alcohol ”

“ By diluting with water to reduce the protein and salts, and adding sugar and a little cream, the proportions of these different substances may be made to approximate those in mother's milk. In both the sugar is the same—lactose, or milk-sugar; the fats are also much alike in each; but the albuminous matter of cow's milk differs somewhat from that of human milk, particularly in the way in which it coagulates in the presence of acids. Human milk forms into small, light, feathery curds; cow's milk into large, compact, not so easily digested masses. ”

“ All yeasts grow best in an acid medium, hence those fermenting milk sugar find suitable conditions for growth in sour milk or whey. They may at times become of economic importance in the cheese industry, because of the contamination of the milk with large numbers of [Pg 97] them. The arrangement of the whey vat is often such that it cannot be completely emptied and cleaned; the sour whey thus presents favorable conditions for the growth of the lactose-fermenting yeasts. ”

“ Since milk alone in such a diet would probably cause such discomfort as to make it unwise to continue it, the ideal diet would seem to be one in which the fats, proteins and carbohydrates are furnished in a semi-solid or solid form, together with a sufficient amount of liquids to prevent too great concentration in the food, to relieve thirst, and to act as a carrier of reënforcing substances, such as lactose, eggs, casein products, etc. ”

“ Very light and easily digestible solid foods, chiefly carbohydrates, are added by degrees, and in the end, five or six small meals, rather than three full ones, are given in the course of the day.
In some cases the patient is induced to drink, daily, two or three quarts of sugar solution (an ounce of lactose to a pint of water) , and to nibble at will on olives, walnuts, crisp crackers, or some such articles of food, which are kept within reach on her bedside table. These are usually retained, excepting in very severe cases, to the patient’s great encouragement. ”

“ Ordinarily three to five ounces per day is sufficient, although some persons cannot safely consume as much as this. In the case of diabetes mellitus, the amount of sugar in the ration must be materially reduced. Persons in normal health and engaged in outdoor work can use sugar to advantage. [29] Many of the "harvest drinks," made largely from molasses with a little ginger, and used extensively in some localities, are not without merit, as they contain an appreciable amount of nutrients. Milk contains more sugar as lactose or milk sugar than any other nutrient. ”

“ Tube, and sterilise as for bouillon.
Ordinary commercial glucose serves the purpose equally well, but is not recommended, as during the process of sterilisation it causes the medium to gradually deepen in colour.
Note.—In certain cases a corresponding percentage of lactose, maltose, or saccharose is substituted for glucose.
Sugar Gelatine.—
1. Prepare nutrient gelatine (vide page 164, sections 1 to 7) . Measure out 1000 c.c.
2. Weigh out glucose, 20 grammes (= 2 per cent.) , and dissolve in the hot gelatine. [Pg 185]
3. Filter through papier Chardin. ”

“ In order to modify or “humanize” cow’s milk so as to make its composition nearly the same as that of mother’s milk, simple dilution with water is therefore not sufficient.
There are, however, various other methods which may be used to advantage. For instance, top-milk from a bottle of fresh milk which has stood 4 or 6 hours in ice water will contain 6 to 8% of fat. By diluting this with an equal part of water, the percentage of protein, fat and mineral matter will be about right, and sugar, either cane-sugar or milk-sugar, may be added to supply the carbohydrates. ”

“ Milk fat or butter is more digestible than almost any other fat, and its importance therefore can readily be realised. All the above constituents of milk fat are composed of different proportions of carbon, hydrogen, and oxygen, but milk also contains minute quantities of lecithin, a fat containing phosphorus in addition. Lecithin is also found in the brain and nerve material of animals, in the yolk of egg, and in several plants.
The nitrogenous constituents of milk—casein and albumen—are usually estimated together, and they are reckoned as of equivalent food value. ”

“ It is apparently true that many physicians have been influenced by these statements in the direction of recommending among their patients a much wider use of fermented milk, and especially of lacto-bacilline, than was previously the case. Moreover many persons have decided without the advice of a physician to make a trial of some form of fermented milk or of some form of lactic acid ferment capable of acting upon milk sugar. It appears that this dietetic practise is still on the increase and likely to modify the habits of a not unimportant part of the community in respect to diet. ”

“ Acid of milk; Acidum lacticum, L. A sour, syrupy liquid, discovered by Scheele in whey. It is also found in some other animal fluids, and in several vegetable juices, especially in that of beet-root.
Lactic acid is by no means an unimportant constituent of the human organism. It is contained in the gastric juice, and is frequently formed in the sweat. It has also been detected in the saliva of persons suffering from diabetes. A modification of the acid, termed sarkolactic acid, occurs in the fluids of the muscular tissue. ”

“ When milk is allowed to stand for some time exposed to warmth and air, a spontaneous coagulation occurs, caused by fermentative changes in the sugar of milk, by which it is converted into lactic acid through the action of germs.
Milk is sometimes adulterated by water, the removal of more or less of the cream, or the addition of some foreign substance to increase its density.
The quality of milk is more or less influenced by the food upon which the animal is fed. Watery milk may be produced by feeding a cow upon sloppy food.
The milk of diseased animals should never be used for food. ”

“ In addition, sterilized milk is a different article from fresh milk, its chemical composition being altered by the process. The milk of the cow, when ingested, is changed upon encountering the gastric juices, into whey, a liquid, and into a tough mass of curd most difficult of digestion. To call milk a liquid food is absurd, for the solid matter in a pint of milk is equal to that in a half pound of meat, and in its dense coagulated form it is vastly more difficult of digestion. ”

“ Many believe that milk and acid fruit should not be taken in the same meal, because the acid curdles the milk. As we have already seen, the milk must be curdled before it can be digested. If this step in digestion is performed by the acid in the fruit no more harm is done than when it is performed by the lactic acid bacteria. Fruit juices and milk do not combine to form deadly poisons. If fruit and milk are eaten in moderation and no other food is taken at that meal the results are good. However, if fruit, milk, bread, meat, cake and pickles make up the meal, the results may be bad. ”

“ It is thus regularly and gradually reduced to curd, and the stomach is not oppressed with a lump of half-coagulated milk. The same principle should be regarded in the case of the adult. Milk should be slowly taken in mouthfuls, at short intervals, and thus it is rightly dealt with by the gastric juice. If milk be taken after other food, it is almost sure to burden the stomach, and to cause discomfort and prolonged indigestion, and this, for the obvious reason that there is insufficient digestive agency to dispose of it. ”

“ The other constituent is the enzyme rennin, which clots milk; this property appears to be useful in that clotted milk will not pass the sphincter into the small intestine as quickly as it would if it were liquid, and so the digestive processes can go on in milk after clotting just as it goes on in any other of our foods. Since milk is the chief, and in many cases the only, food of the young it is of course very important that its digestion should be very efficiently carried on. As the food is churned by the stomach muscles, it becomes mixed with gastric juice. ”

“ If the child had been fed on cow's milk the symptoms may be due to the gastric juice not having been able to dissolve the curd, which you will remember is much firmer than that of human milk as well as twice as abundant. In this case the substitution of asses' milk, the employing whey either entirely or in part instead of milk, and the adding white of egg in order to present the elements of the curd in a more easily digestible form, may all be tried with advantage. Sometimes children refuse whey ”

“ It includes not only the true lactic acid types in which no gas is formed, but those species capable of producing gases and various kinds of acids. These organisms are the distinctively milk bacteria, although they do not predominate when the milk is first drawn. Their adaptation to this medium is normally shown, however, by this extremely rapid growth, in which they soon gain the ascendency over all other species present. It is to this lactic acid class that the favorable flavor-producing organisms belong which are concerned in butter-making. They are also indispensable in cheese-making. ”

“ The sugar is turned into lactic acid, which combines with the casein and when this process has continued for a certain length of time the result is clabbered milk or sour milk. The length of time varies with the temperature and the care given the milk. If milk remains sweet for a long time during warm weather, discharge the milkman and patronize one whose product sours more quickly, for milk that remains sweet has been subjected to treatment. All kinds of preservative treatment cause deterioration. ”