MILK SICKNESS. 
By George W. McCoy. 
Passed Assistant Surgeon, Public Health and Marine-Hospital Service. 
Definition . — Milk sickness is an acute, nonfebrile disease, probably 
of a specific nature due to the ingestion of milk, milk products, or 
the flesh of animals (usually cattle) suffering from a disease known 
as trembles. The disease in man is characterized by great depres- 
sion, persistent vomiting, obstinate constipation, and high mortality. 
Synonyms . — Endemic sick stomach, sloes or slows, milk sick, sick 
stomach, colica trementia, puking complaint, paralysis intestinalis, 
mukosma, syro. 
Historical . — Milk sickness was first noted and its association with 
trembles in cattle first defined about the beginning of the last century. 
The earliest professional account appears to have been published by 
Drake in 1809, and was based upon the observations of Dr. Thomas 
Barbee. Since that time the disease has become an important part 
of the medical history of our middle west. 
In some localities the disease was so prevalent and fatal that whole 
communities migrated from “ milk-sick ” sections to parts where the 
disease did not occur. 
With the advance of civilization, as forests were cleared and pas- 
tures fenced, the disease became less frequent; by the time of the 
civil war the disease was by no means common. At the present time 
it is one of the rarest of diseases. Trembles in animals is now almost 
as rare as “ milk sickness r in man. The latest outbreak of which I 
have knowledge occurred in Macon County, Tenn., in April and May, 
1907. Isolated outbreaks are reported in some parts of Tennessee 
every two or three years. The cases now occur only in the thinly 
settled regions, usually remote from lines of communication. Most 
frequently the cases are attended by a layman, known locally as a 
“ milk-sick ” doctor, who has a local reputation for curing the dis- 
ease. This accounts for the fact that the malady has not been studied 
by modern methods. 
Milk sickness in man (and trembles in animals) was such an impor- 
tant question in the early years of the last century that several State 
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