Nutrition in wasting diseases of children and adults / by David Walsh.

  • Walsh, David.
Date:
1904
Catalogue details

Licence: In copyright

Credit: Nutrition in wasting diseases of children and adults / by David Walsh. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Reprinted front (3 Cfeulat Vol. CXXIX. WEDNESDAY, NOVEMBER 2, 1904. NUTRITION IN WASTING DISEASES OF CHILDREN AND ADULTS. By DAVID WALSH, M.D.Edin., Senior Physician, Western Skin Hospital, London, W., &c. Of recent years there has been a marked ten- dency to lessen the use of drugs in the treatment of not a few diseases. As we all know, many complaints formerly treated by physic are now forthwith handed over to the operating surgeon. In a host of other maladies the medical man nowadays turns for aid to physical methods, such as the “ high frequency ” electrical current or hot air baths, or to the old-fashioned remedies of good food, travel, exercise, pure air, and sea-bathing. In the present article the chief point that will be dealt with is that of food-nutrition in relation to wasting disease. The subject was suggested to the writer by various medical friends, who reported excellent results in such cases from the use of a particular food, Sanatogen. On inquiry, I found that the nutrient product in question had, during the past five years or so, been extensively used in Germany, where it had been favourably spoken of by many eminent men, including Professors Ewald, Tobold, Neisser, Walther, von Schroetter, Duhrssen and others. Their results, published in various medical journals, were so remarkable as to suggest a kind of specific nutrient value in this new food. On further reference I found that Sanatogen was being advertised in the Lancet, British Medical Journal, Medical Press and Circular, and other leading professional journals. There could be no doubt, therefore, as to its acceptance and standing in the medical world. At the same time it seemed desirable to learn more as to its qualities by a systematic clinical investigation. Accord- ingly, it was determined to put the matter to a careful trial. This has been done in a scries of selected cases, some of them taken from private and others from hospital practice, in which all details have been accurately noted. My results, briefly stated, have confirmed those of the above mentioned Continental observers. They have been sufficiently striking to warrant the belief that in Sanatogen we have a nutrient food of more or less specific absorbability into the system, and hence of considerable nutritive value in all cases of acute or chronic tissue starvation. The composition of Sanatogen is stated to be 95 per cent, of pure casein (milk albumin) with 5 per cent, of glyccro-phosphate of sodium. Many foods have an apparently equal nutritive value, but every medical practitioner knows how difficult ( is to nourish a patient suffering from disease- /maciation. The wasted body remains wasted in spite of abundant feeding with eggs, milk, pep- tonised foods, meat extracts, and the round of No. 18. invalid diet. Do we not all recognise the fact that the starving tissues are fed, not by the food swallowed by the patient, but by the amount of nutrient matter absorbed by the gastric and intestinal mucous membrane ? If we could ensure the absorption of nutriment into the blood, the problem of nutrition in disease would be reduced to a matter of mere chemistry and me- chanical feeding. Failing that somewhat remote contingency, it is conceivable that some way may be found of preparing a foodstuff as to render it readily absorbable in the alimentary canal, no matter how disturbed and weakened the digestive functions may have become. Judging from clinical results, Sanatogen appears in many cases to possess some such power of ready absorbability, without which the richest foodstuff represents simply so much foreign matter in the stomach and intestines. My own experiences are here recorded as a simple extension and confirmation of the remarkable statements of the distinguished Con- tinental authorities already cited. It is to be hoped that medical men here in the United Kingdom will ascertain for themselves the value of this dietetic remedy in wasting diseases, in convalescence, and, indeed, wherever there is evidence of general malnutrition. A certain number of the cases experimented upon were those of wasting children, or “ wasters,” as they are technically called. One of the greatest difficulties with which the physician can be faced, either in hospital or in private practice, is to restore the general nutrition of these little patients. In spite of the utmost care in the regulation of diet the mortality among these children is extremely high. The wasting is obviously a sign of defective nutrition, and the loss of body- weight persists regardless of the quantity or quality of the food introduced into the stomach. The explanation is probably that nutrient matter is not absorbed because of some atrophy or imperfect development of the structure or functions of the glandular and absorptive ap- paratus of the stomach and intestines. Wasting from insufficient food may be taken as the simplest form of infantile atrophy. General tissue star- vation may also be due to the taint of tubercle, especially in the form of tabes mesenterica or of syphilis. Rickets is another predisposing cause, although, happily, it is becoming much less frequent nowadays. Other causes, again, are “ fevers ” and various invasions by pathogenic organisms. The prominent symptoms of almost all forms of infantile wasting are, diarrhoea, vomiting and anaemia. The chief point about the wasting is its persistency—repeated weighing reveals no increase in weight. The diarrhoea is a constant symptom, with stools that are as a rule green and offensive, but at times they are yellow with greenish streaks. The vomiting is persistent and