1912.] 



The Metabolism of Lactating Women. 



97 



creatin excretion and mammary gland activity, other evidence, in addition 

 to that offered, is necessary. It would be advantageous if, for instance, it 

 were possible to calculate directly the amount of milk secreted by a nursing 

 woman. This was not found to be possible. The following indirect evidence, 

 however, may now be considered : — 



(b) A Case of Creatin Excretion and Mammary Gland Activity developing 

 late after Childbirth. — The next point to be observed is that when a 

 woman's breasts have their activity delayed, following childbirth, then there 

 is a corresponding delay in the creatin excretion. This patient* may be 

 described as a case suffering from a toxaemia of pregnancy, and showed the 

 characteristic symptoms of this condition, namely, general oedema, headache 

 and occasional temporary attacks of blindness. She also excreted much 

 albumen. She never had any eclamptic fits ; and. although very ill, labour 

 was not induced, but came on naturally at the end of the eighth month. 

 At the birth of the child the breasts were soft and without any trace of 

 activity. They became gradually active about the fourth day after delivery, 

 and at this time also creatin, which had been, up till this time, quite absent, 

 began to appear and increase. 



Mrs. T. (toxaemia of pregnancy). Weight of baby, 3^ lb. Eighth month. 



Date. 



Creatin 

 Creatinin' 



Albumen (by Esbach), 

 approximate. 







grm. 



February 2 



Trace of creatin 





7 







12 





7 7 



„ 15 





4-77 



16* 





5-17 



„ 17 



>' j> 



4-03 



„ 18 



>> n 



4 6 



19 



0-15 



0-C6 



„ 20 



-21 



1 -9 



„ 21 



-35 



-46 



„ 22 



0-36 



o-o 



24 



0-57 



o-o 



March 2 



0-3 





„ 5 



0-18 





„ 8 



0-16 





* Time of delivery, February 16, 10 a.m. 



In this case the creatin excreted was too small to be estimated until the 

 third clay after delivery. 



* The case was met with in an investigation of the toxsemias of pregnancy, undertaken 

 in conjunction with Dr. J. P. Hedley. 



