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

  • Walsh, David.
Date:
1904
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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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    symptoms had disappeared, and the urine was free from sugar. Her powers of walking gradually returned, and in a month she was able to walk half a mile on level ground twice a day without much inconvenience. Case VI.—K. L., a girl, aet. 3, brought to me by her mother for advice on account of “ weakness.” Family history good ; child fairly well nourished ; had enteritis of four weeks’ duration when one month old, and bronchitis lasting three weeks with two convulsions at the age of one year. Has always been “ delicate ” and nervous ; cannot walk far, as she complains of pain in her knees. Teeth good ; moderate “ knock- knee ” ; height 37^ inches ; weight 32^ pounds (fifteen months previously 32 pounds). No or- ganic or constitutional disease was found. The only suspicious point was the almost stationary weight, which in an ordinary healthy child of her age should clearly have increased many pounds in the course of fifteen months. She was ordered Sanatogen, one teaspoonful twice daily, and at once began to put on weight at an average of half a pound weekly. The error of nutrition, in this instance of obscure origin, appears to have been effectually remedied by a simple dietetic treat- ment. Case VII.—M. N., a gentleman, of middle age, who had suffered for eleven months from epithelioma of the soft palate. About the second week in September, 1904, he had reached an extreme stage of emaciation, and had taken for several weeks to his bed, from which he had before that time been carried downstairs in a chair. Sanatogen was ordered in teaspoonful doses twice daily in milk. A marked improve- ment in the general condition rapidly followed. The hollows in the cheeks and temples became much less visible, and after a time the patient actually walked downstairs, and interested him- self in painting picture-frames and so on. More striking still was the fact that he several times asked for and ate a boiled egg, although he had taken nothing but “ spoon ” diet for months previously. In this case Sanatogen produced a distinctly favourable effect on the general nutrition and condition. The improvement was far more marked than happens in the occasional “ turn for the better ” met with in most cases of malignant disease, and lasted for many weeks. Although I have had no experience personally of the use of Sanatogen in convalescence from enteric fever, a medical friend has found it in- valuable under those circumstances. Anything that can help one to tide over the anxious period of typhoid convalescence will be sure of a warm welcome by medical men. For many years it was the invariable rule both in hospital and in private practice not to give any food beyond milk, cream, and beef-tea until the temperature had been normal for ten days. During that time of probation patients craved for food incessantly, and suffered much distress from restless nights and from the pangs of hunger. This rule was gradually relaxed ; first coffee and then mashed bananas and cream were allowed, and the time of probation shortened. It is now admitted by many good authorities that solid food may be given in milk after the fourth day of normal temperature with absolute safety. The comfort of the patient is thereby much increased, and his convalescence shortened. In this and in the [3] other conditions above mentioned, Sanatogen deserves a careful trial by medical practitioners, as a readily assimilable form of semi-solid food. It is readily prepared, moreover, a point of some importance in the sickroom. On the Continent, Professor Ewald (n) has spoken warmly of the value of Sanatogen in enteric fever. He administered that food to a patient on the fifth day after admission to hospital early in the third week of an attack of typhoid fever. As the result of experimental investi- gations he concluded that Sanatogen is valuable, on account of its ready absorbability, in all cases of physical weakness, “ as well as in the acute stages of all those maladies which are accom- panied by high rise of temperature and particu- larly in enteric fever.” Dr. Eduard Rybiezlca (6) advocates the use of the same preparation in convalescence from the malady in question. Case VIII.—A lady, set. 50, single, complaining of stiff joints and wasting. Her mother died of phthisis, also a brother. When young she had an attack of St. Vitus’dance, after falling downstairs. Between 20 and 25 she suffered from chronic cough, and was treated for incipient consumption. General health had been good ever since, and she had been of active habits, and took a great deal of outdoor exercise. Seven or eight years ago her hands began to get stiff and painful, and later the feet, elbows and knees were involved. The hands showed the typical deformities of advanced osteo-arthritis ; the fingers were en- larged at the joints, and those of the right de- flected outwards and clawed ; large swellings, both bony and bursal, were present on the backs of hands and wrists. The right hand was worse, as the fingers were partly clawed into the palm and the wrist also partly locked. There were tender spots on the hands, but for the most part tenderness and pain were absent. The feet, elbows and knees were more or less involved ; the elbows could not be straightened, and there was a great deal of “ egg-shell ” deposit about the knees, especially the right. There had recently been a considerable loss of weight, although the appetite remained good. A careful search failed to reveal tubercle in the lungs or elsewhere, and no disease of heart, kidneys, or other organs accounted for the loss of weight This patient was treated by the super-heated air method, introduced and perfected by the late Mr. Tallcrman. The joints soon gained in power of movement, and the joint swellings diminished rapidly in size. At the same time the general health improved greatly. Sanatogen was ordered at the outset in teaspoonful doses twice daily. The patient was first seen on October nth, when she weighed 6st. 9lbs. Sanatogen was first given on the 14th in teaspoonful doses thrice daily, increased gradually to two teaspoonfuls. The weight began to increase at once, and on October 28th the weight was 6st. 1 ilbs. This case shows the value of a readily absorb- able food in the perverted nutrition of a general disease like osteo-arthritis. The great loss of weight is met with occasionally in cases of rheu- matoid arthritis in which there is no gross organic disease. A well-known physician has recently published several cases of extreme wasting in (ft) Zeitschrift fur dielettsche and phynikalisdie Therapie. Von Leyden. Article bv Dr. 0. A. Ewald. ih) Wiener lctinische lVochenschviftt 1900. VoJ ix.