Uric acid in the clinic : a clinical appendix to "Uric acid as a factor in the causation of disease" / by Alexander Haig, assisted by Kenneth G. Haig.
- Date:
- 1910
Licence: In copyright
Credit: Uric acid in the clinic : a clinical appendix to "Uric acid as a factor in the causation of disease" / by Alexander Haig, assisted by Kenneth G. Haig. 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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![Here, again, we have a marked history of chronic collaemia and lieadache, and we find a large heart, very slow skin circulation, and high B.P., together with the signs of failing heart and its results, defective combustion of albumin and sugar. Possibly still curable, but he did not give me a chance, and most likely went for codeina, strict diet, with excess of poisons and early destruction. Case 14.—T. M.,male, aged 63. Had diabetes in the spring of last year; then in the autumn rheumatism suddenly came on, and diabetes went or got better, and rheumatism is now his chief trouble. Pains now are worse in the morning and in bed, go away as day goes on (collcemic arthj-itis ?). His father had rheumatism. Was a healthy man till late years. Had influenza, followed by gastric catarrh, and diabetes followed that (the bearing of this on tlie causa- tion of collcemic and defective combustion is obvious). Is stout, face flushed, and vascular (vejious congestion). Conjunctiva slight yellow tint. Sleeps fairly, or would do so if not for pains. Appetite poor, especially fir breakfast. B.D. -8; pulse 96 ; C.R. 7 ; B.P. 135. Apex beat diffused, first sound long, second sound loud. Has some flatulence, bowels act once a day, no piles. Took codeina for the diabetes. Micturition once in the night, urine passed here full amber, sp. gr. 1029, acid, albiimin, ? trace, reduces bismuth, sugar not estimated. Weight 12 st. i lb., once was 16 st. Present diet: meat twice, soup twice (very fond of it), egg or bacon once, whisky and soda twice, cocoa once. I gave aspirin gr. XV. ter p.c, and advised him to give up soup, and to take cocoa as a mere flavouring. I then got a sample, quantity not mentioned, sp, gr. 1027, strongly acid, a trace of albumin, sugar 3'3 per cent. I increased the aspirin to four doses in twenty-fom- hours. Seven months later I saw him again. He says he is well, except for a little stiSness about the ankles and knees, and some nasal and throat catarrh in the mornings. Sugar fell to 1 per cent, on the aspirin three months ago ; has not been taking it regularly of late. Pulse 86 ; C.R. 9 ; B.P. 110 ; B.D. -85. Has some flatulence in the morning, but is not thirsty now. Present diet: meat once, fish or bacon once, soup once. Urine passed here 10 a.m. sp. gr. 1028 ; full amber, clear, acid, sugar 3'3 per cent., no salicine reaction, no albumin. I advised him to go on with the aspirin regialarly, as it will keep down both the rheumatism and the sugar, and to make his diet still more U.A.F. When sugar is at or below 1 per cent, may increase his breadstuffs, especially in the evening. The case is interesting, as it appears that the sugar diminished very decidedly and ceased to cause anxiety with the onset of the arthritis: i.e., the codeina caused some storage and this diminished collaemia and the glycosuria, its result. Case 16.—M. B., female, aged 26. Complains of pain in ba^k.and stomach which is increased by food. Began to have great thirst (7 to 8 or 10 pints a day) about two years ago. Father and sister died of diabetes, one brother and one sister well. Vomited two or three round worms eight months ago. Headache now and again all her life. Had diarrhoea last summer in the heat, neuralgia and dental pain in the winter. Skin hot and dry. Lost much hair two years ago when diabetes first came on (sign of collcBmic circulation). Is mentally irritable and very nervous, especially when tired (signs of heart failure). Nights bad and restless, sleep deficient, appetite poor of late, tries to make up with Plasmon biscuits. B.D. -75 ; pulse 108 ; C.R. 10 ; B.P. 135. Apex beat slightly to left, second sound relatively loud, i.e., first sound poor. (She ivould have high B.P. (200) if heart ivere strong enough to j^roduce it [virtical tension].) Has slight cough in morning and had a bad cold three months ago. (Probably this cold did harm, by helping to dilate right side of heart and increase venous congestion.) Liver dulness full size, stomach down to umbilicus. There is some duiness in](https://iiif.wellcomecollection.org/image/b21994109_0227.jp2/full/800%2C/0/default.jpg)
