A text-book of medicine : for students and practitioners.

  • Adolph Strümpell
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: A text-book of medicine : for students and practitioners. Source: Wellcome Collection.

    1027/1108 page 999
    Oertel regards it of great importance to diminish the amount of water in the sys- tem, a point which has until very lately received little attention. The diminution m the amount of fluids may ameliorate any circulatory disturbance (vide supra) and relieve venous congestion, and it undoubtedly has some value in the treat- ment of obesity. Oertel has shown that a simple diminution in the amount of fluids ingested, when there is no other change in the diet or mode of life, will effect a diminution of the adipose tissues. This result is probably due mainly to the diminished strain upon the heart and the consequent increase of oxidation; but the chief cause of the rapid loss of weight, which we actually see in the cor- pulent as a result of the deprivation of fluid, is to be found not in the loss of fat, but in the marked loss of water contained in the body. “ Desiccation ” may further be promoted by stimulating the perspiration by bodily exercise or by steam baths. This withdrawal of liquid from the system, however, is advisable only in cases where there is already incipient cardiac failure. It is evident that numerous excellent methods are at our disposal for the treat- ment of obesity; but their application to any particular case should be the result of a careful consideration of the special circumstances presented. A very essen- tial point is that the injunctions of the physician should not merely be made, but be carried out; and it is precisely here that the treatment of many cases suffers shipwreck. We may be baffled by the patient’s lack of energy and persistency, or by the importunate demands which his profession or social position make upon him. Indeed, it is sometimes absolutely impossible to prosecute the treatment at home, in which case bathing and health resorts are to be urgently recommended. There alone can the patient muster up the resolution necessary for carrying out the desired changes in his mode of life. The incontestable success of treatment at Carlsbad, Marienbad, Kissingen, Tarasp, and similai’ resorts is doubtless only to a very small extent the result of their specific medicinal influence, but it is mainly due to a strict observance of the above-described diet and regimen. The internal use of mineral waters is not entirely without a beneficial effect. Their laxative qualities diminish the absorption of food from the intestinal canal. It should be said, however, that the patient is at the same time exposed to the danger of a waste of his nitrogenous tissues. This is why patients frequently complain of the debili- tating effect of these mineral springs; to avoid which, it would be well to increase the amount of albuminoids in the diet. We must also consider the need of guard- ing against too great a supply of fluid, with regard to what was said above as to the occasional service of “ desiccation ” of the body. CHAPTER XIII. SCROFULA. Definition and Symptoms of what is called Scrofula.—We desire to pi’esent, at the close of this section, a brief description of scrofula, but merely from a practical standpoint. From a scientific point of view scrofula is not to be regarded as any special variety of disease. The term is applied to a group of symptoms seen most frequently in childhood, the essential features of which consist in the appearance of chronic enlargements of the lymph-glands, and in certain diseases of the skin and mucous membranes. The simultaneous appearance of these various jiheiiom- ena does really produce a somewhat characteristic picture, which can frequently be recognized at the first glance. Most scrofulous children api)ear pale, with a flabby .skin and soft muscles.
    No text description is available for this image
    No text description is available for this image
    No text description is available for this image