Heart starvation / by J. Milner Fothergill.

  • Fothergill, J. Milner (John Milner), 1841-1888.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Heart starvation / by J. Milner Fothergill. Source: Wellcome Collection.

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    medical practitioners are to be induced to study the features of each individual case, and to lay down a plan of treatment adapted to the requirements of each case ? I confess it is not easy to see. The pressure on their time in large practice militates against such patient thought; and these cases are not common enough to make them quite familiar with the subject. It is necessary to remember first, that when the tongue is not clean, and the function of the liver is disordered, it is worse than useless to give iron (see “ When not to give Iron,” Practitioner's Hand¬ book of Treatment, 2d edition). The liver and the assimilative processes must first be put to right, and then chalybeates may be given—but not before. As to medicines, it may be well to give a pill, the old-fashioned dinner pill, containing ipecacuan with a vegetable laxative. Ipecacuan is an hepatic stimulant of no mean potency ; or iridin, or euonymin may be substituted. Then a little strychnia or digitalis may be added, according to the indications of the case. Twice a week, first thing in the morning, it may be well to give a dose of sulphate of soda with Rochelle salts, to sweep away a quantity of waste by the bowels, especially bile surplusage. This is the medicinal part of the subject. Now comes the dietary. A small quantity of albumenoids thoroughly digested furnishes more pabulum to the tissues, more material from which the tissues can be fed, than will a large meal, of which none or very little is completely digested. The tissues may be starved when the stomach is filled to repletion with food rich in albumenoid material. The food should consist of fish, fruits, fat, and farinaceous material -— such dishes, indeed, as are given in Food for the Invalid; where a variety of suitable culinary receipts will be found. On such a dietary it will be seen that the patient gains weight as the nutrition of the tissues is improved. It is well, too, to aid the natural digestive efforts by giving pepsin, or the liquor pancreaticus advocated by Wm. Roberts in his recent Lumleian Lectures. After a certain improvement has actually taken place it may be well to proceed to administer chalybeates. The following case illustrates what may be attained by appropriate well-selected treatment even in a very unpromising condition. Mr A., only 48, but looking much older, and presenting a decided