190 



ON THE TRANSFUSION OF MILK. 



[1855. 



Nature would then merely have to regenerate the lost epithelial 

 cells, which would of course be a work of time ; and no efforts of art 

 could remedy this defect ; if the amount of the epithelial exfoliation 

 had been very excessive, the exhaustive discharges of the choleraic 

 diai-rhcea would go in spite of all our injections; for the intestinal 

 mucous membrane would then be in the condition of the dermis denuded 

 of its epidermis by artificial vesication ; exosmosis must occur by 

 serous transudation until the protective covering had been reformed, 

 when endosmosis would again recommence from the re-establishment of 

 the physiological action of these wonderful cells. 



Hoping that some members of the Association may have the oppor- 

 tunity to put these suggestions in practice, and be able to communicate 

 the results through the Journal to the profession. 



I am, etc., W. B. Hekap.^tii. 



Bristol, August 1854. 



This letter, coming from so distinguished a chemist, gratified 

 me very much ; and from it I gather that the use of milk in 

 transfusion, and as a substitute for blood, is novel, and what- 

 ever little credit, therefore, is due to so humble a suggestion, 

 must be awarded to Toronto, where its use was not only sug- 

 gested, but actually put into practice. 



The fact that milk (provided it has not parted with life) may 

 be injected into the human system by the veins is now estab- 

 lished; and it remains to be seen how far it may be useful as a 

 remedial agent, not only in cholera, but as a restorative in cases 

 of Uterine Hoemorrhage, or Hoemorrhage from loss by wounds. 

 In the cases in which it has yet been tried, all other means were 

 exhausted before the attempt was made to inject the milk; and 

 I am informed, both by Dr. Daniels and Mr. McKenzie, that 

 after my attendance on the cholera patients ceased, in no case 

 was transfusion attempted, until every one present concluded 

 that the patient was actually dying. I regret exceedingly that 

 my own serious illness should have prevented my continuing 

 to visit the patients, as I was thus prevented carrying out the 

 observations; enough, however, was witnessed to show, that, 

 while we may expect much good from transfusion, it cannot be 

 expected to restore to health the body in which serious local 

 disorganisation has taken place : the earlier the collapse, and 

 the sooner the milk be used, the better. 



Dr. Owen Rees, in a very late publication, thus expresses 

 himself: — " With regard to the chemical constitution of the 

 fluid, it would appear that we can scarcely venture to interfere 

 with the organic constituents of the blood, nor imitate the 

 animal extractions and protein compounds of the circulating 

 fluid, in order to supply them if deficient. There is, however, 

 no occasion for this in Asiatic cholera, for the evacuations 

 from the intestinal surface which destroy the healthy cha- 

 racter of the blood in that disease, appear to contain but 

 little organic matter, being chiefly made up of water, holding 

 the salts of the blood in solution. Thus Vogel and Wittstock 

 agree in describing cholera evacuations as containing intestinal 

 mucous, traces of albumen, and the ordinary salts of the blood 

 with carbonate of soda somewhat in excess. The analysis 

 of cholera blood again points clearly to the necessity of 

 supplying more especially salts and water, if we desire to 

 restore it to the healthy standard." Now, if we take a 

 review of the composition and properties of milk, it will be 

 found to possess all the qualities alsove desired by Dr. Eees. 

 Thus the distinguished chemist Simon remarks, " that perfectly 

 fresh milk has always a decidedly alkaline re-action, and it 

 retains this property for a longer or shorter time : the milk of 

 woman retains its alkaline re-action longer than that of cows, 

 and the milk of healthy women longer than that of invalids." 



On examining the milk under the microscope, we perceive a 

 great number of fat vesicles of very different sizes swimming in 



a clear fluid, and occasionally epithelium cells. From repeated 

 comparisons 1 have found that the fat vesicles in the milk of 

 women are generally larger than those in the milk of cows In 

 addition to these, we observe, under certain circumstances, 

 other microscopic objects. The fat vesicles have, as Raspail 

 declared, a solid envelope, a point which has been confirmed 

 beyond dispute by Henle. Raspail considers that it is composed 

 of coagulated albumen ; it is, however, more than probable that 

 it consists of caseine. Henle has shown that this capsule may 

 be dissolved Ly acetic acid, and that butter then issues from it. 

 It is probable, however, that this fluid fat becomes enclosed in 

 a new envelope, for Ascherson has observed that a membrane 

 immediately forms around every drop of fat that is brought in 

 contact with a solution of albumen ; and have found, says M. 

 Simon, that fat shaken with a caseous substance (crystalline) 

 in a state of solution, causes a partial coagulation by the forma- 

 tion of such membranes or capsules. 



" When milk is left.to itself," continues Simon, "for a con- 

 siderable time, it coagulates, in consequence of the con- 

 version of a portion of its sugar into lactic acid. This 

 change often takes place very rapidly in coio's milk, and 

 generally more quickly than in woman's milk." By re- 

 ference to the analysis, it will be seen that in every particular 

 cow's milk alive, and therefore fresh, possesses every necessary 

 quality, as already observed ; there is fuel for the sustentation 

 of animal heat, and salts to supply the place of those drained 

 away, mixed not by any cunningly contrived art of man, but in 

 vital combination with a living fluid ; for I think that we ought 

 not to lose sight of the fact that, when we speak even of the 

 water of blood, that we speak of water in a particular state, for 

 it certainly must possess properties differing from the ordinary 

 properties of water, and so on with every other constituent 

 of the blood. 



COW'S MILK. 



Water 8570 



Solid constituents 143-0 



Butter 40-0 



Cassia 720 



Sugar and Extractine "I „„ „ 



Matter / -^'^ 



Fixed Salts 6-2 



E.arthy Salts 



Phosphate of Lime 2-31 



Phosphate of Magnesia 0-42 



Phosphate Peroxide Iron 0-07 



Chloride of Potassium 1-44 



Chloride of Sodium 0-24 



Soda 0-42 



PROXIMATE CONSTITUENTS OF THE BLOOD. 



Protein Compounds : — Fibrin, Albumen, Globulin, 



Colouring Matters : — Hcematin, Hoemaphein. 



Extractive Matters : — Alcohol extract, Spirit extract. Water extract. 



Fats : — Cholesterin, Serolin, red and white solid fat, containing 

 Phosphorus, Margaric acid. Oleic acid. 



Salts : — Iron. Albuminate of Soda. Phosphates of Lime, Magnesia 

 and Soda. Sulphate of Potash. Carbonate of Lime, Magnesia and 

 Soda. Chlorides of Sodium and Potassium. Lactate of Soda. Oleate 

 and JIanganate of Soda. 

 Gases : — Oxygen. Nitrogen. Carbonic. Sulphur, &c. Phosphorus. 



DE. rees' analysis of chyle. 



Water 902-37 



Solid constituents 97-63 



Fibrin 3-70 



Fat 36-01 



Albumen 35-16 



861-0 



823-0] 





139-0 



177-0 





38-0 



55-0 



a 



68-0 



67-0 



I a 



29-0 



51-0 



03 



6-1 



13-0 





47-1 



3-44 50-7 



8-6 



0-64 9-5 



1.4 



07 1-0 



29.4 



1.83 27-1 



4-9 



0.34 5-0 



8.6 



0.45 



6-7 



