Some considerations in regard to acute obstructive diseases of the lungs / by Andrew H. Smith.

  • Smith, Andrew H. (Andrew Heermance), 1837-1910.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Some considerations in regard to acute obstructive diseases of the lungs / by Andrew H. Smith. 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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    nutritive material than can be fully acted upon through the agency of the respiration, not only fails to add to nutrition, but is a positive burden to the already overtaxed vital powers. Such excess must be thrown out of the system, and vital energy must be expended in getting rid of it; and meantime it is everywhere a hindrance to the vital functions. Now it is precisely those alimentary substances which we would select on account of the ease with which they are digested and absorbed which for the same reason are most likely to be taken into the circulation in harmful excess. In this view it might even be better for the patient, if he must be overfed, that his food should be of a less digestible character, as the excess would do less harm in the alimentary canal than in the bloodvessels. We are apt to give freely of albuminous substances, and too often the instinctive craving for simple water to dilute the blood and facilitate its passage through the lungs is met by the constant proffer of milk, beef-tea, etc., in which the water is spoiled for nature’s purpose by the addition of unnecessary food. If then we find albumin in the urine we refer it to the con- gestion of the kidneys, instead of regarding it as an indication that the blood is surcharged with the products of digestion. In view of these facts it becomes necessary to observe close- ly the effects of the nourishment given, and to assure our- selves, not only that the food is properly digested, but that it does not increase the embarrassment under which all the func- tions of the body, and especially the respiration, are laboring. I am strongly of the opinion that if we study our cases close- ly with this in view we shall find more justification than we were prepared to admit for the very restricted diet which formerly was so much in vogue in the management of acute diseases of the respiratory organs. The danger here, let me repeat, is not from general exhaustion. It takes time to bring this about, as we see demonstrated even under the exhausting conditions of typhoid fever. But in the case before us the vital machine, as a whole, is clogged; it is only the right heart that is exhausted, and this not because it is underfed, but be- cause it is overworked. Let us be watchful then, that the