98 



Mr. E. Mellanby. 



[Oct. 3, 



On February 18, 5 drops of colostrum were squeezed from the breasts. 



19, J oz. colostrum was withdrawn in the morning. By 



6 P.M. 1 oz. could be withdrawn every two hours. 



20, lactation established. 



As this baby was too feeble to suck, the milk had to be first withdrawn 

 from breasts. 



It is interesting to compare the creatin excreted by this toxpemic patient 

 with that of a normal case of pregnancy where labour came on prematurely 

 at the eighth month. She was in good health, and nursed her baby from 

 the first. 



Mrs. B. (normal case). Premature labour. About eighth month. Weight 



of baby, 5^- lb. 



Date. 



Creatin 

 Creatinin" 



February 7 



0-29 



„ 14* 





15 



0-22 



16 



31 



17 ..... 



0-34 



IS 



0-78 



19 



0-49 



21 



0-27 



23 



-28 



* Baby born February 14. 



In this case the creatin excretion was always present, and increased, as 

 after the birth of normal full-term children, for a few days. This is in 

 marked contrast to the case of Mrs. T., where the creatin is absent before 

 delivery, and until the breasts become active. Another interesting point 

 about this toxasmic case is that the appearance of creatin synchronises with 

 a large decrease of albumen in the urine. It appears as if the cause of 

 the albuminuria was also the cause of the suppressed creatin excretion. 

 A similar case of toxaemia of pregnancy has been met with. 



(c) A Case Illustrating Simultaneously Suppressed Creatin Excretion and 

 Mammary Gland Activity. — Another piece of evidence that creatin 

 excretion and mammary gland activity are related is as follows : if a con- 

 dition arises, in the first few days after milk secretion is fully established, to 

 suppress the milk secretion, then the creatin excretion stops at the same time. 



In the following case, N". was delivered of a baby on May 25. The milk 

 was abundant, and the child developed very well until June 1, when the 

 left breast developed an abscess, and the temperature rose to 102°. This 



