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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![Case 32.—T. C, male, aged 32. Complains of dyspepsia, and everything seems to turn acid. Has suffered with this acidity of stomach with some headache for three years. No fevers. Influenza seven to eight years ago. Head feels as if the top was lifting up when stomach is empty between meals ; this is cured by food. Is nervous and excitable, also depressed at times. Sleeps fairly when not disturbed by stomach. B.D. -8 ; pulse, 80 ; O.R. 6-5 ; B.P. 125. (These ivere at i 2>-m-; C.R. would be slower and B.P. higher in the morning.) Apex beat is in left nipple line; first sound long or reduplicated, second slightly loud. During digestion his head swims and all his food goes acid. Bowels only open with Carlsbad salts. The lower border of the stomach is below the umbilicus, and there is a splash. The right kidney can be felt, but is not tender. Urine normal; he is an analyst and examines it himself. Weight 145 lb. {He has obviously got dyspepsia from the defective [collcemic] circulation, and head troubles are due to tlie same cause.) Has put himself on a modified U. A.F. diet for four months, and appears a little astonished that it has not done him good. Is making many mistakes; continues meat once a day, and excess of fluids in the form of hot water, also porridge and slops and many meals (four) in the day, also dried milk preparations, the digestion of some of which in collsemic f)atients is doubtful. He was taking excess of hot water before he tried to be U.A.F., as he had j)re- viously been on a beef and hot water cure for six months. Meat digested well, but did not seem to do him any good, and he lost strength on it {i.e., in his weakly and dyspeptic condition the urates at once passed into the blood and increased the colkemia). I did what I could to put him on a more suitable diet and to cut down his fluids, but he had got so far wrong that he could only be got slowly back towards normal. I tested his digestion of some of the dried milk proteids, and found that when they were properly in solution he produced urea equal to two-thirds of their value in three or four hours, so that he seemed to digest them fairly in this form, but he still required a more solid diet. I got him to leave oS his morning hot water, and he soon felt decidedly better for doing so. Later I found one morning a pulse of 68; B.P. 130, and C.R. 8 {here obviously the pressure loould have been higher but for the diminished fluid, so that the improvement noted tvas due to this and not to diminished collcemia). I advised him to go on with diminished fluids and to take some nux as a tonic and occa- sional bicarbonate of soda for his stomach. I here made, as I see now, two mistakes. The pulse being slow no nux was required, and the stomach should have been got right by clearing up the collaemia with acids, fruits, &c., and spacing the meals, one, or at most, two meals a day, and not by bicarbonate of soda, which would increase the collsemia, even if it temporarily reUeved the stomach. The removal of collaemia and the treatment of the circulation is in these cases all important. Asthma. Case 1.—P. G. A., male, aged 30. Complains of asthma for fourteen years, except two years ago when he got married and was well for a whole year. Father had the same as a young man, but it left him at the age of 32 when he got the gout. {A retention disease curing a collamic one.) Health otherwise good. Attacks begin at 2.30 a.m., after being asleep, and go off about 12 noon, except when he is bilious {collamic), and then it may last all day. Pulse 96 soft, his doctor says it is tense at times. Apex beat in left nipple line. Sounds normal. Urine thick at times of attack, often pale before attacks, showing fluctuations in collfcmia. I advised him to alter his diet, and he then told me that ho was all right as a lad while on very plain bread and milk diet, but asthma came on when he went to town at sixteen, got more money and so ate more meat. {He)-e tvas the parallel of my own headaches, sedentary life in town increased](https://iiif.wellcomecollection.org/image/b21994109_0135.jp2/full/800%2C/0/default.jpg)
