1912.] The Metabolism of Lactating Women. 93 



Cow. 





(; rpi t" nun in 

 \Jl Co. llillll 111 



Orciitm in 



Creatin 





10 c.c. 



10 c.c. 



Creatinin 







m °" mi . 





June 2 



6 



2 -7 



0-45 



3 



8 



2 6 



-325 





10 -1 



4-1 



0-405 





9-0 



3 2 



0-356 



„ 6* 



8-5 



3 5 



0-41 





6<i 



5 3 



0-8 



„ 8 



6-0 



4-0 



0-67 





6 -2 



3-0 



0-48 



" 10 



6'0 



4-3 



0-71 



* Calf bom June 6, 4 a.m. Placenta eaten by 10 a.m. 



It will be seen that a rise of creatin excretion follows the ingestion of the 

 placenta rather than a fall. Consequently it is unlikely that placenta eating 

 explains the absence of creatin in a rabbit's urine post partum. 



The investigation was continued on women and this will now be described. 



(a) A Quantitative Relation between Creatin Excretion and Milk Secretion in 

 Nursing Women. — The women were patients at a lying-in hospital * and the 

 diet in all cases was creatin-free, in that no meat, fish or meat extracts were 

 given. Such a dietf has great drawbacks because of the desire, mentioned 

 above, which these women have for meat and tasty food. The disappoint- 

 ment at the plainness of the diet often makes them depressed, and the 

 mental condition is soon reflected in the poor progress made by the child, 

 either because it is not properly nursed or because the mother's milk is of 

 poorer quality. This difficulty was especially obvious in cases of multipara? 

 who had been in the lying-in hospital before and were therefore accustomed 

 to plenty of meat. Most of the cases studied, therefore, were primiparse, in 

 whom this mental depression was not so obvious. 



Below are the figures obtained in the examination of four normal cases of 

 childbirth. They were all on the same diet and were living in the same 

 ward under precisely the same conditions. 



* The Lambeth Lying-in Hospital, S.E., to the staff of which, and in particular to 

 Dr. J. S. Fairbairn, I wish to express my indebtedness. 



t A typical day's diet, though it varied to some extent, was as follows : — Milk 25 oz., 

 gruel 5 oz., cocoa (made of milk) 5 oz., an egg, bread and butter 5 oz. Occasionally liver 

 up to 4 oz. was added. 



