Clinical lectures on diseases of the urinary organs : delivered at University College Hospital / by Sir Henry Thompson.

Thompson, Henry, Sir, 1820-1904.

Date:: 1882

Credit: Clinical lectures on diseases of the urinary organs : delivered at University College Hospital / by Sir Henry Thompson. Source: Wellcome Collection.

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$home in fifty or sixty days, attain the i object as certainly and more safely. I ( hj no means dispute that there are other 1 cases which may be benefited by the ■ jnore heroic plan adopted on the spot, I ( have largely and systematically employed ] these agents more than twenty years, : modifying the quantity and the mode as experience has indicated, and the system thus briefly described is the result of it. The course may be repeated with advant- cige, if necessary, for many patients after an interval of three or four months. Mean- time, as an occasional aperient and as a corrector of digestion in these case, few things are better than the aperient waters named. They leave the patient as a rule less constipated after discontinuing it than he was before ; and, as already said, may be taken habitually without lowering the system. I have known patients continu- ing their daily use for three or four years, but I cannot advise this course unless in exceptional cases. Nevertheless, 1 know a gentleman, nearly eighty years old, who has taken it for five years regularly, a wine-glass every morning, and the effect lias been for him most admirable. Suffer- ing much lormerly from an obstinate con- stipation, he enjoys perfect regularity and excellent health. Let me say here that the ' Carlsbad salt' just referred to is often used in the belief that it represents Carlsbad water. You have already learned that it consists almost entirely of sulphate of soda taken from the water, and has the same and no more virtue than such a salt obtained from any other source. No doubt the sulphate of soda, known also as ' Glauber's salt,' is one of the most admirable medicines we possess, and deserves to be more popular than it is. 1 have constantly ordered it, with or without a small addition of sidphate of magnesia, for the out-patients of the hospital, as the best substitute within their reach for the mineral waters in question. There are some cases in which very small doses of blue-pill may be most usefully employed; those naturally in whom the appetite and digestion do not much improve under the use of the water alone. 1 am quite satisfied in most instances with an eighth of a grain com- bined with three or four grains of com- pound rhubarb pill, and taken every night, or every second night, during the former part of the course. Many persons in whom doses of two or three grains cause painful depression derive manifest benefit from the small quantity named. If any one doubts the effect of an i or even of the -^^ ^ grain of blue pill, let him try the ordinary five-grain compound rhubarb pill, with and without the fractional addition, and the difference will be easily understood. In the few minutes wdiich remain I will advert briefly to the subject of diet, certain restrictions in which are extremely important. It used to be said that when uric acid is largely deposited, the nitro- genous elements of the food should be considerably diminished. I do not find in practice that a strict application of this rule is advantageous. On the contrary, diminution pf the deposit is more cer- tainly attained by a course which is almost the opposite of that. There are three elements among matters ordinarily taken as diet which in order to attain the end in view must be permitted to the patient very sparingly—viz., alcohol, saccharine and fatty matters. First, alcohol : any fermented liquor permitted as an article of diet should be selected in its more diluted and in its purest form. No doubt, for most patients, the best course is to relinquish altogether the habit of taking it. That it is not only not essential to health as a rule, but is absolutely prejudicial to most persons, I am firmly convinced; but especially, however, to the ' torpid liver' is it deleterious. No doubt, after long ex- perience of the use of wine and beer, total abstinence at first entails no little hard- ship on some persons. They feel keenly for two or three months, or even more, the loss of their customary stimulus. In most instances, however, when this term has been passed, they are better, stronger, and no longer feel the want of alcoholic liquor. But if the sacrifice is too great, or if there is a reason to believe that it is desirable, at all events while commencing the course of waters, not to make so great a change—and that is, I think, the prefer- able course—I advise that form of alcohol which exists in light natural wines, such ■ for example as a light sound Bordeaux, ; or a Rhine wine of similar quality, the former perhaps agreeing better with most persons here. You wall forbid champagne, ■ as for the most part imperfectly consti- ! tuted, and always bad if containing much 5 of the sw^eet compound often largely$