ON THE MECHANISM OF MILK SECRETION : THE INFLUENCE OF INSULIN AND PHLORIDZIN.

The four types of experiments on milk secretion herein described really fall into one general class so far as the physiological effects produced are concerned. Starvation lowers the blood sugar and raises the osmotic pressure of the blood. The experiment using parathyroid hormone with or without starvation may have its effects interpreted as simply due to starvation since 1000 units of this hormone produced no visible effects on the blood calcium or milk constituents different from those of starvation. Since insulin produces a marked and rapid drop in blood sugar it too may be looked upon as a rapid starvation effect. It has some other important effects, however. Briggs et al. (21) have shown that potassium and phosphorus of the blood are decreased and Luck, Morrison, and Wilbur (22) indicate a reduction in the amino acids of the blood in insulin treatment. Phloridzin lowers the threshold for sugar retention with the consequence that in time it tends to lower the sugar of the blood to an even greater extent than that noted in starvation. It tends to depress the potassium, to increase the phosphorus content of the blood, and to cause the body to burn protein rather than carbohydrate, thus increasing nitrogen excretion. All of the experiments are characterized by a sharp reduction in the milk yield. Cary and Meigs (23) have studied like reductions in milk yield produced by varying the energy or protein of the diet. They conclude that such decrease in milk production may be interpreted as due to the direct effect of the starvation and the consequent reduction of the energy and protein available to milk secretion. The reduction in milk yield for the experiments herein described can undoubtedly be attributed to the same causes as those cited by Cary and Meigs. The experiment where Cow 47 was given a full ration and at the same time injected with large quantities of insulin is of particular interest in this connection. The ration was adequate and the cow ate well, yet her production declined to a fifth of her normal milk yield. Her chart shows that there was a slight reduction in her blood sugar when insulin was introduced into the blood stream. It seems furthermore likely that this sugar was not as available to milk secretion, since there appears to be more than a corresponding drop in the lactose content of the milk. The work of Luck et al. would seem to indicate that there should be a like drop in the amino acids of the blood. These two conditions would lead, according to the work of Cary and Meigs, to a reduction in the concentration of the nitrogen of the milk. Actually, in the experiment as it was performed, the nitrogen increased to a value about 40 per cent above normal. A somewhat similar conflict is noted in two of the other three insulin experiments where starvation accompanied insulin injection. To this extent it would seem that the factor deserving most emphasis in its immediate effect on milk yield is the energy available, and that the later and more secondary factor is the amino acid concentration of the blood. In the starvation experiments, the butter fat percentage of the milk rises rather uniformly with the duration of starvation. In the insulin experiments, however, the charts appear to show a marked reduction in this butter fat percentage immediately after the introduction of insulin. This is particularly noticed after the second and third injections. Since the dextrose of the blood tends to be reduced and made unavailable to the general physiological processes by the presence of the large excess of insulin, and since this reduction of the butter fat percentage is noted as an accompanying phenomenon, it would appear that the blood dextrose plays a part in the synthesis of milk fat as well as being the source of the milk lactose, possibly as a source of energy in converting body fat to butter fat. In this regard the results for the treatment of Cow 47 with phloridzin are of importance. As noted by others, the introduction of phloridzin causes a marked rise in the fat percentage of the milk. The lactose per cent is also higher than that noted in starvation. Since phloridzin, by lowering the threshold for the blood sugar, causes large quantities of it to be drained from the body through the urine, and therefore reduces the reserve supply, it follows that if the insulin hypotheses are correct we should expect an eventual lowering of the lactose and of the fat below the starvation level. During the last of the experiment this is what was actually observed. The effects of starvation and of insulin furnish concordant proof for the theory that the lactose of milk is derived from the sugar of the blood. The fact that the different constituents of the milk, the fat, the lactose, the nitrogen, and the ash, do not exactly parallel each other in their behavior throughout these experiments indicates that they have in all probability separate origin. This is particularly true of the butter fat percentage, which appears to have a rate of secretion which is more or less independent of the other constituents, and higher in amount. This result would fall in line with the conclusion of the writers in a previous paper in which it was indicated that the fat of the blood was very likely deposited in the udder as fat corresponding to body fat from which source it was metabolized into the fat of milk shortly before it was needed for milk secretion. The wide variation brought about in the constituents of the milk by the treatment all point to the conclusion that in milk secretion a balance is maintained between the osmotic pressure of the milk and of the blood. Thus when the sugar of the milk is reduced either through starvation or by insulin the ash constituents rise to compensate for this reduction and make the osmotic pressure of the milk similar to that of the blood. These results further appear to indicate that the salts and the sugars are more or less independent in their passage and metabolism into milk from the other constituents. These observations are therefore in line with those obtained by Jackson and Rothera (14) and by Davidson (15) in their brilliant experiments where they modified milk secretion by returning milk or milk sugars and salts to the udder. These experiments give direct proof for the conclusion that modifications of the blood of dairy cattle produce direct and predictable modification of the milk secreted.