110 MILK SUGAR 



a therapeutic agent for the cure of just such cases as they were 

 supposed to produce. 



Clinically, then, excessive amounts of lactose may cause a 

 chain of symptoms, namely, fever, diarrhoea, leucocytosis, pros- 

 tration and death, which closely resemble the effects which fol- 

 low the absorption of certain true bacterial toxins. Experi- 

 mentally, too, it is possible to show that lactose fed in excess 

 to pups will cause a similar picture. Pups about six weeks old 

 were fed increasing amounts of lactose in sterilized milk. At 

 first, the pups increased in weight more rapidly than the controls, 

 were very active, and seemed perfectly well. Upon still further 

 increasing the sugar, the weight increased more rapidly for a 

 while even after the stools had become thin and frequent. Quite 

 suddenly there was a decided change. The pups began to lose 

 weight rapidly, lost their desire for food and had numerous 

 watery stools. During the next three days their flesh just 

 seemed to melt away, and they died in a very emaciated condi- 

 tion, without any special symptoms. The sudden change, from 

 fat, well nourished pups to sickly, emaciated animals in the short 

 period of two days reminded one of the way in which infants 

 just seem to fade away during an attack of cholera infantum. 

 Increasing the amount of sugar produced also an increase in 

 the rate of gain in weight up to the point where the tolerance 

 limit was overstepped, then came the breakdown in metabolism 

 and the rapid loss of weight that ended fatally in three days. 

 The controls that were fed on the same sterilized milk without 

 lactose addition gained weight more slowly, but showed none of 

 the acute symptoms of the sugar-fed pups. In none of the pups 

 was there any urinary evidence of an acidosis. 



Although there can be no doubt that the sugar is an agent 

 in causing these effects, there is a question as to whether lac- 

 tose, per se, is the substance primarily responsible, or whether 

 its excessive administration facilitates the entry of other toxic 

 substances into the circulation. The modus operandi is of theo- 

 retical and practical importance. Comparatively recently Leo- 

 pold and Reuss have made the observation that when lactose 

 is injected subcutaneously into infants and dogs there occurs a 

 quantitative excretion in the urine, if only a single dose is given. 

 If the injection is repeated daily, the amount of lactose which 

 appears in the urine falls until finally no lactose at all is excreted 

 by the kidneys. It has been hinted that the gradual increase of 

 tolerance for lactose so administered is analagous to the develop- 

 ment of immunity by repeated doses of a true toxin. If this be 

 true, it is of the greatest importance this immunity action to 

 lactose, a compound of very simple chemical formula. 



