since it would make for economy in the administration of the machinery of the body. Equally important and desirable are reliable observations on the effect of fermented milks on the absorption of milk fats and milk proteins in various types of intestinal infection with their accompanying acute and chronic catarrhal inflammation of the mucous membranes of the digestive tract. The therapeutic claims put forward by enthusiastic advocates of the use of fermented milk have in general taken a different direction and have concerned themselves much more with the question of the reduction in intestinal putrefaction than with increase in absorption. But it must not be overlooked that an improved absorption of proteins is one of the most important conditions in general for reducing intestinal putrefaction, because whatever favors prompt and complete absorption must correspondingly limit the opportunity for decomposition. In a lesser degree this statement holds true also of the fats. I have been able to show experimentally that in normal persons the butter-fat may be much increased above the usual intake—say from fifty grams to one hundred and fifty grams daily—without materially increasing putrefactive decomposition. On the other hand, such an increase in butter-fat in persons already suffering from increased putrefactive decomposition shows a pronounced tendency to still further increase the putrefaction. I attribute this tendency to the mechanical obstacle to prompt absorption of proteins arising from the presence of fat in abundance. The failure in prompt absorption of proteins from an intestine infected with putrefactive microorganisms means intense putrefaction, whereas a similar failure in a healthy intestine is far less significant owing to the relative infrequency of putrefactive bacteria.
In considering the therapeutic influence of fermented milk, it is necessary to take into account the fact that in such milk the carbohydrate material has been in a large degree replaced by the products of fermentation. Where milk is used in only small amounts in the dietary, and these small amounts are replaced by a fermented milk, the difference in quantity in respect to the intake of carbohydrates may be so small as to be negligible. Where, however, the dietary consists largely of milk and this large amount of milk is replaced by an amount of fermented milk equivalent in protein and in fat, the difference in respect to the carbohydrate material may assume considerable importance. In the case of the unfermented whole milk, there is enough milk sugar to markedly encourage fermentative decomposition in the intestine with the production of considerable gas. The gas-forming organisms especially likely to attack the milk sugar are B. lactis cerogenes, B. coli and B. cerogenes capsulatus (B. welchii, or B. perfringens). In cases where there is marked flatulence from the use of whole milk, the use of any fermented milk in which the milk sugar
