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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    urgent, and occurs immediately after food of any kind whatever. The ancemia is characterised by erythrocytes of not more than two millions to the cubic millimetre, while the leucocytes are increased to, say, 12,000, and the haemoglobin value may be anything between 36 and 64 per cent. These patients are apt to get pneumonia, usually of the broncho-pneumonic but sometimes of the lobar variety. In looking for the cause of infantile wasting with the above train of symptoms, the physician will naturally note any past or present evidence of “snuffles,” rash,delayed closing of fontanelles, or of any of the various bony or glandular changes associated with tubercle, rickets, or syphilis. Whether specific drugs be or be not required, it goes without saying that dietetic treatment must always be of first importance in such conditions. My own experience of Sanatogen, as shown in the appended cases, is that it stays the diarrhoea—ten or twelve motions a day are thereby reduced to one or two ; it stops the vomiting, and it improves general conditions and causes the patient to put on flesh. Finally, it brings about some amount of improvement in the coloured corpuscles, which increase at the rate of about 10,000 per c.mm. daily. These results, due, as I believe they are, to such simple means, are worthy of the careful attention of every medical man who is called upon to deal with wasting diseases. Case I.—A. B., male child, aet. one month ; brought to hospital with a history of diarrhoea, vomiting and wasting from birth. There were usually from eight to ten green, slimy and offen- sive motions in the twenty-four hours. The child had “ snuffles,” and was covered with a syphilitic rash all over the body. It was breast- fed, but a little cow’s milk diluted with one-third lime water had been given from time to time. The weight was only 4% pounds. Treatment included grey powder, inunctions of mercurial ointment, and the administration of subnitrate of bismuth, both in small and in large doses. The incessant vomiting, however, went on un- checked, and, humanly speaking, there seemed to be not the least chance of recovery. At this point all medicinal treatment was discontinued, and the infant ordered a teaspoonful of Sanatogen in a mixture of milk and cream every four hours. This combination was taken well, and in less than twenty-four hours the vomiting and diarrhoea had ceased. The child gained half a pound in weight in a week, and made a good recovery. The foregoing case speaks for itself. It has an extremely suggestive value as regards the relation of general nutrition to the curative action of specific drugs upon the body. The following case illustrates the use of Sanatogen in stopping diarrhoea and vomiting in a wasted child, where there was no evidence of any specific disease. Case II.—C. D., a female child, aet. four months ; brought with a history of almost continuous diarrhoea since birth. There were many motions daily, of a yellow colour streaked with green, and very offensive. Milk, cream, and many kinds of “ infant foods ” had been tried in vain ; nearly all of them’excited vomiting. The child weighed only six pounds, was thin and pale, with an irregular temperature ranging between 98° and ioi°. There was no evidence of syphilis nor of tubercle. The red blood corpuscles numbered 4,150,000, the leucocytes 11,000, whilst the [2] haemoglobin value was 61 per cent. Sanatogen given in two-drachm doses every four hours promptly stopped the diarrhoea and lessened the vomiting. In four days the temperature had fallen to normal, and at the end of a week the red cells had risen to 4,230,000 and haemoglobin value to 62'5 per cent. The treatment was con- tinued for some time, and careful weighing showed that the child gained weight at the rate of about a quarter of a pound a week. The following cases show the value of this new form of food nutrition in various wasting con- ditions :— Case III.—F. F., female, single, aet. 18, waitress in a London tea-shop ; complaining of palpitation and shortness of breath. For three years she had suffered periodically from attacks of anaemia and amenorrhoea. She was liable to fainting fits, especially when actively engaged in a hot room. The conjunctivae and the mucous mem- brane of the lips were pale. Her red blood corpuscles numbered 3,500,000 per c.mm., with a haemoglobin value of 42 per cent. She lived chiefly on tea and bread and butter, and it was only with much difficulty she was able to continue her employment. After relief of constipation she was ordered Sanatogen in milk as a staple article of dietary. This she took without difficulty, and in a fortnight her red cells improved at the rate of 10,000 a day. Her symptoms gradually sub- sided, and at the end of a month she was able to take her meals with a good appetite, and was free from all appearances of anaemia. Case IV.—G. H., a married woman, ast. 36, suffering from melancholia. She had sustained a severe shock from the sudden loss of her favourite child. She took to her bed and practically refused all food with the exception of beef-tea, milk and jelly. She lost weight rapidly, and suffered from profuse sweating at night. No sign of tubercle, however, could be detected in the lungs or elsewhere. She was anaemic, and her red corpuscles numbered only 3,800,000 per c.mm., with haemoglobin 48 per cent. She was placed on Sanatogen, and at once began to improve. Her mental equilibrium was restored, she deve- loped fresh energy, and at the end of a fortnight was able to resume her home duties. Her red cells had by that time risen to 4,000,000 per c.mm. and the haemoglobin to 52 per cent. The im- provement in this case was most striking and suggestive. Case V.—T. J., an elderly widow lady, had suffered for many years from chronic bronchitis and emphysema. Of late she had developed glycosuria ; the amount of urine passed in the day measuring on an average six pints, with a specific gravity of 1025. She lost little flesh and there were no other symptoms of diabetes. She had been carefully dieted by a physician, under whose direction all sugar and starch were ex- cluded. Unfortunately, from the state of her teeth she was unable to masticate the various substitutes for bread which were from time to time suggested. Her heart was dilated, and she suffered much from dyspnoea on exertion, even when the latter was slight, such as going slowly upstairs. Flatulence was another great trouble, and eructations were almost incessant. The dietary was relaxed, and she was placed on one- ounce doses of Sanatogen in milk every four hours. In less than a week all her subjective