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
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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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    worked hycollcemia). Suffers a good deal from wind, always constipated, motionB never natural, has to take laxatives. Stomach slightly enlarged, and splashing. Abdominal pain bettor when constipation is relieved. One child four years ago, parturition followed by thrombosis and fever. Case published in Lancet, 1893 : Self-abuse for years ; begun as a child, and worse when she has a headache. This is evidence of chronic collaemia with high B.P., whicli the self-abuse relieved j)ro tevi. It is interesting to note that the Kuhne cold baths are a slight stimulus to the sexual organs as the cold vi^ater is dashed against them; but their chief effect is tonic, anti-collaemic, and retentive, like cold bathing, especially if indulged in in the morning. Has a tendency at times to take wine to excess. Present diet consists of bread, puddings, fruit, some eggs, one pint of milk, and some water early in the morning. Kuhne gave nothing but fruit at first, and the bowels began to act almost at once. Has capital appetite now, and is very hungry. Feels stronger and better on her present diet. Her nerves are better in the autumn, and worse in the spring (i.e., varywith the causative collcemia). This case may be summed up as migraine, chronic collaemia with complications, slight heart failure under collaemia, nerves, depression, and stimulant cravings, with the effects of cold baths, and partial U.A.F. diet on these conditions. I advised her to reduce her five meals to three or two, and to reduce her fluids. In two months she reported that dj'spepsia (wind) was better, and abdominal pain was also better, though constipation had not diminished. Urine sp. gr. 1013, acid, trace of albumin due to leucorrhoea. She then got uj)set because her child was ill, and went ofi her food; has not been able to keep to two meals (yet this is the only thing that would have kept her appetite good). Her best aperient is one containing mag. sulph., sodii sulph., and lithii carb., which, no doubt, acts as a retentive; fruit would be better than this. Case 8.—E. M., female, aged 23. Complains of nervous excitability and in- somnia. Used to suffer from headaches, insomnia worse since headaches got better. Mother nervous and excitable. Headaches from childhood, one in ten days. Scarlet fever at school. Has often been anaemic, on iron and bromidia of late. B.D. 9 (i.e., good, no ancEinia now, yet the nerves and insomnia continue). Sleeps on going to bed but wakes at 4 a.m. Pulse 72, first sound long, second sound loud (no doubt a collcemic heart). Has had occasional menorrhagia, headache, not worse at the period. Urine sp. gr. 1030, acid, no albumin, no .sugar, some excess of uric acid. Weight 7 st. 12 lb. in clothes, or say 7 st. 5 lb. net. Has been three weeks on U.A.F. diet, but milk seems heavy and causes flatulence. I saw this patient with Dr. Armstrong, of Buxton, and I advised her to go on two meals a day, and reduced her fluids to one pint of milk, calculating the necessary proteids and giving her the rest as cheese and breadstuffs. Six weeks later I heard from Dr. Armstrong that she had greatly improved, and was continuing the diet as ordered. (It just happened that this case, treated twelve years ago, was put on very nearly the treatment I noiv make use of in similar cases, though tcitli moderji instruments and methods one can adjust things much more accurately.) Case 4.-—M. N., male, aged 32. Complains of cough for six months. Loss of voice two or three weeks. Voice rough for some time. Morning expectoration, white. Is doing sedentary work in an office, but walks backward and forward. Pre- vious health good. Has been a vegetarian for two and a half years. Has had frontal headache the last few weeks. Appetite good, sleeps well, except for some cough at riight. B.D. -75; pulse 100; C.R. 6-5; B.P. 120; temperature 99-2. Apex beat in left nipple line. (? Heart of chronic collcemia, on tuhich pJithisis has supervened.) Has all signs of phthisis in the lower lobe on the right. Expansion