THERAPEUTIC ACTION OF FERMENTED MILK 33 



since it would make for economy in the administration of the machinery 

 of the body. Equally important and desirable are reliable observa- 

 tions on the effect of fermented milks on the absorption of milk fats 

 and milk proteins in various types of intestinal infection with their 

 accompanying acute and chronic catarrhal inflammation of the mucous 

 membranes of the digestive tract. The therapeutic claims put forward 

 by enthusiastic advocates of the use of fermented milk have in general 

 taken a different direction and have concerned themselves much more 

 with the question of the reduction in intestinal putrefaction than with 

 increase in absorption. But it must not be overlooked that an im- 

 proved absorption of proteins is one of the most important conditions 

 in general for reducing intestinal putrefaction, because whatever favors 

 prompt and complete absorption must correspondingly limit the oppor- 

 tunity for decomposition. In a lesser degree this statement holds true 

 also of the fats. I have been able to show experimentally that in nor- 

 mal persons the butter-fat may be much increased above the usual 

 intake — say from fifty grams to one hundred and fifty grams daily — 

 without materially increasing putrefactive decomposition. On the 

 other hand, such an increase in butter-fat in persons already suffering 

 from increased putrefactive decomposition shows a pronounced tend- 

 ency to still further increase the putrefaction. I attribute this 

 tendency to the mechanical obstacle to prompt absorption of proteins 

 arising from the presence of fat in abundance. The failure in prompt 

 absorption of proteins from an intestine infected with putrefactive 

 microorganisms means intense putrefaction, whereas a similar failure 

 in a healthy intestine is far less significant owing to the relative infre- 

 quency of putrefactive bacteria. 



In considering the therapeutic influence of fermented milk, it is 

 necessary to take into account the fact that in such milk the carbo- 

 hydrate material has been in a large degree replaced by the products 

 of fermentation. Where milk is used in only small amounts in the 

 dietary, and these small amounts are replaced by a fermented milk, 

 the difference in quantity in respect to the intake of carbohydrates may 

 be so small as to be negligible. Where, however, the dietary consists 

 largely of milk and this large amount of milk is replaced by an amount 

 of fermented milk equivalent in protein and in fat, the difference in 

 respect to the carbohydrate material may assume considerable impor- 

 tance. In the case of the unfermented whole milk, there is enough 

 milk sugar to markedly encourage fermentative decomposition in the 

 intestine with the production of considerable gas. The gas-forming 

 organisms especially likely to attack the milk sugar are B. lactis 

 cerogenes, B. coli and B. cerogenes capsuJatus {B. welchii, or B. per- 

 fringens). In cases where there is marked flatulence from the use of 

 whole milk, the use of any fermented milk in which the milk sugar 



VOL. LXXIV. — 3. 



