Collected essays in preventive medicine : infection & disinfection, temperature observations on children, the period of infection in epidemic diseases, and the renal signs of disorders of nutrition / by William Squire.

Squire William, 1826-1899.

Date:: 1887

Credit: Collected essays in preventive medicine : infection & disinfection, temperature observations on children, the period of infection in epidemic diseases, and the renal signs of disorders of nutrition / by William Squire. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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$the persistence of glycosuria increases the tendency to renal disease, and a meat diet, by checking the one, would prevent the other. It is only where the quantity of albuminous food far exceeds the assimilative powers that albuminuria results. Claude Bernard notes this occurrence after a large number of cooked eggs had been eaten; my own experience is, that six boiled eggs may be eaten at one meal with no ill result. Dr. Lauder Brunton, after six raw eggs, had headache and sickness, but no albuminuria. ])r. Grainger Stewart records three cases {^Practitioner, Vol. XXXIX., No. II., p. 109) where nine and ten raw eggs were taken daily in addition to the ordinary food for three, seven and nine days with temporary albuminuria; two ounces of cheese with an ordinary meal in twenty lads had no effect of this kind. The rule here is the same as for milk diet; avoid excess, and be careful not to impair digestion. Both albumin and sugar in small quantities are frequently found when digestion is imperfect. The after changes of assimilation and nutrition are more obscure than those of mere digestion ; they consequently lead to greater discrepancy of view and wider range of theory. A return to the discarded acetone theory reproduces the old errors of the alkaline plan of treatment in diabetes. When Chevreul, now an active centenarian, first shewed that an alkaline state of the fluids , favoured oxidation of the heat-forming elements of food into carbonic acid and water, a theory arose of diabetes resulting from want of alkali in the blood, and consequently carbonate of soda was given in large doses, in some cases to the extent of four or five drachms daily for ten or fifteen days. The results of six cases so treated were published in 1846 ; in all both the quantity of urine and the percentage of sugar were increased, the latter in some cases to a very great degree. Two of the more advanced cases died, one of pneumonia and one of coma; known accidents of the persistent disease which soda can neither directly produce nor in any wise prevent or avert. The blood is not acid in diabetes, but the urine is: and the new theory would connect this acidity with the acetonEemia of the past. Minskowski finds much of this acidity due to p, oxybutyric acid ; this splits into aceto-acetic acid and carbonic acid, oxidation of aceto-acetic acid or of oxy-isobutyric acid, will yield acetone. But acetone only sometimes appears in diabetic urine, and when present in the blood under other conditions, or however administered, has been proved not to produce the symptoms that have been ascribed to it Yet a writer in Cassell's Year Book of Treatment (for 1885, page 67), assumes a toxic agent in diabetic coma, derived from the butyric or formic acid series, which is to be got rid of by alkalis, the vapour bath, and perspiration. In support of this view, a case is mentioned where Hoppe-Seyler found acetone m the urine after poisoning by sulphuric acid ; but, as acetonfemia$