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
Catalogue details

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.

    236/326 (page 222)
    ♦222 for eight to ten days more {i.e., generalcollcemia, a rebound after the above named tonics and refentivcs), and he had some vomiting and slight jaundice. A week ]ater he was better, but had lost 14 lb. in weight in this attack. A few days later he again got a chill with pains in the loins. Three weeks after that he was taking strychnia and dilute hydrochloric acid and doing well on them. Then he got pain in the right hypochondrium (poor liver again) and the water was thick {recurrent collcemia); was also given nux, aloes, jalap and euonymin for the bowels {the chemists atvijst did well out of this patient). Then he got pains in the loms and testes, had been taking Vichy water {solvent) and it did harm, then he took Contrexeville {a retentive) and it did good. The last prescription to complete his consumption of the British Pharmacopoeia contained pepsine, sodii. bicarb., sp. aether, and juniper. After this, as was not extraordinary, he got weak again, and again went in for Schott treatment, and his nurse said he was badly nourished, and gave more food; he was fed night and day, on raw beef juice, beef jelly, egg, Benger, cocoa and the whole list of poisonous stimulants. After a time they had an effect and he got stronger and in better spirits, and his urine increased from 22 oz. to 43 oz. in twentv-four hours {i.e.. collcemia again passed off, and by the aid of excess of food and poisons he was got to retain once more). After this he went home with the intention of taking a prolonged rest and going abroad, and it was then that I saw him and found the conditions recorded. He only has headache about once a week now, and this is removed by tea {lie is completely in the habit of removing the effects of poison by more poison). His present diet contains meat twice or three times, fish twice, soup once, tea two cups {a fine lot of poisons for a most obvious case of uric acid poisoning). I advised him to go abroad and rest, and later to come to me and have his diet put right. This he never did, so probably he came in for more poison stuffing and drug dosing, and then heart failure or Bright's disease, or both, for they are often synonymous, ended the matter for ever. I give the case for the interesting history of headache alternating with heart failure, and when I saw him there was very little to distinguish his condition from that of Graves's disease, the etiology of which is also lighted up in an interesting manner. Some en- largement of thyroid, with heart failure and prominent eyes, is fairly common in female migrainers, but this is the only male in whom I have found such marked signs of its onset. If his heart gets stronger he will get granular kidney, and die of cerebral haemor- rhage ; if it does not he will have Graves's disease or a more acute form of Bright's disease, and die of heart failure. Yet all that was wanted when I saw him was simply to leave off the introduction of fresh food poisons, and in two or three years there would be no trace left of any of these troubles, which on the other course were rapidly becoming dangerous to life. Case 6.—F.B., female, 34. Complains of weakness and pains aU over. Headache, anorexia, constipation, dyspepsia, anasmia and faintness. Ailing for a long time, never very strong. Has had migraine for years, very bad and always worse at the monthly periods. Had anaemia very badly at 19. E5'es are somewhat prominent, and there is some general enlargement of the thyroid. B.D. -75; pulse 140 regular, later fell to 132 ; C.E. 8; B.P. 180. Her chief complaint was her headache, for which I treated her with bromide and salicylate, and got the bowels open with magnesimn sulphate. Later I advised U.A.F. diet, but she belonged to that class of patient who will take any quantity of drugs and expect them to do what is impossible {i.e., to remedy food poisoning wliile tlw jMisons ore being continued}, but they do not understand a change of diet, and •either will not or cannot do it.