Diabetic coma / by Balthazar Foster and Robert Saundby.

  • Foster Balthazar W. (Balthazar Walter), Sir, 1840-1913.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Diabetic coma / by Balthazar Foster and Robert Saundby. 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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    passed tliis morning is acid, clear, greenish coloured, sp. gr. 1035, contains ^ col. of albumen, a large quantity of sugar, and gives an unmistakeable deep vinous-coloured reaction with ferric chloride. His eye- sight is unaffected. On the day of admission the patient took ordinary diet, but all this day he has been on diabetic diet. The detection of the ferric chloride reaction at once suggested the fear that coma might be imminent, and as the bowels had not been moved for forty-eight hours, two scruples of pulv. jalapae co. were administered at 12,30 p.m., and he was ordered to be carefully watched. j p.m.—Patient became very restless, and complained of great pain in his abdomen; his respirations were deeper, and his pulse quick and feeble. The pain in the abdomen was relieved somewhat by hot fomentations. The bowels had not been moved. 5p.m.—Pulse 156, feeble; resp. 34. Ordered a tea- spoonful of brandy every half hour. y.jop.m.—No cyanosis; respirations deep and sighing; pulse very feeble ; complains of no pain. Not restless, seemed rather drowsy. Ordered three teaspoonfuls of brandy at once, and a teaspoonful every ten minutes. 7 p.m.—Patient quite comatose ; thirty minims of ether injected subcutaneously did not rouse him, nor did he appear to feel the operation of having a drop of.blood taken from his finger. After a little he roused sufficiently to put out his tongue and to say that he felt short of breath, but no pain. There was no cyanosis ; breathing was very deep, 41, pulse (before the ether) 174, extremely feeble. Pupils were dilated, but reacted to light. Breath- ing very harsh ; heart sounds scarcely perceptible. The blood on examination did not contain anv^ fat clobules but the leucocytes appeared slightly increased. An enema