100 



Mr. E. Mellanby. 



[Oct. 3, 



was followed by abscesses in the right breast. Both breasts were too 

 painful for nursing the child, and, as the result of the abscesses and 

 hyperpyrexia, the secretion of milk was rapidly and totally suppressed. 



It might be supposed that, since in this case the creatin excretion and 

 the milk secretion were synchronously suppressed, any case of suppression 

 of milk secretion, produced by the ordinary methods of banding and purga- 

 tion, would also cease to excrete creatin. This is not the case, as the 

 following figures show : — 



M 18. Confined September 5, 1911. Prolapse of cord, still-born child, 

 placenta preevia. Had nursed previous children. Treatment : — Breasts 

 bandaged tightly, two or three purges each day. 



Creatin 

 Creatinin " 

 September 12 0*79 



15 0-78 



16 0-70 



It will be seen that nob only is the creatin not suppressed in this case, 

 but is higher than the normal cases of nursing women given above. If, 

 then, the mammary glands in such a case were without milk, and completely 

 flaccid, it would disprove the relation of creatin excretion and mammary 

 gland activity which it has been the object of this paper to establish. In 

 point of fact, on September 16, the breasts of this woman, in spite of all 

 the purgation she had experienced, contained abundant milk, and were hard 

 and knotty. 



On September 8 she had a temperature of 10 02°, due, no doubt, to 

 the congestion of the mammary glands. There is no doubt that purgation 

 and breast bandaging do not suppress mammary gland activity in the 

 sense that illness, particularly when there is fever, does. A feverish 

 condition seems to produce very quickly soft, flabby breasts, markedly 

 different from the hard, knotty breasts of a woman treated by purgation. 

 In keeping with this is the fact that in the one case the excretion of creatin 

 is diminished, and, in the other, is as high, or higher, than normal. 



4. The Effect of Adding Casein to the Diet of a Pxicrperal Woman. 



Having got some evidence of a relation between mammary gland activity 

 and creatin excretion, the investigation was continued in order to determine 

 whether there is any obvious relation between particular branches of the 

 metabolism of secreting breasts and creatin. 



