Further observations on the use of pancreatic emulsion and pancreatine, in consumption, marasmus, tabes mesenterica, and other wasting diseases of children and adults / by Dr. Dobell.

  • Dobell, Horace, 1828-1917.
Date:
[©1872?]
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Licence: Public Domain Mark

Credit: Further observations on the use of pancreatic emulsion and pancreatine, in consumption, marasmus, tabes mesenterica, and other wasting diseases of children and adults / by Dr. Dobell. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    not quite; aud then they should be carried back another and another six months, until a time is reached at which they have not the least doubt, either from actual weighing or general impression, that they were at their full weight and full firmness. It must be remembered that loss of firmness, which is, chiefly, loss of solid fat replaced by olein, often precedes actual Avasting by a considerable period. This is a change which careful and watchful mothers will observe in children as the first sign of degrading health, and those who are judicious enough to take warning by it, will often, by change of air and of diet, save their children from any further mischief. Increase of fat with loss of firmness in the fat is a certain sign of improper feeding or of impaired assimilation, and such fat will disappear, like snow before the sun, on the occurrence of the first attack of even a trifling acute disease. Having ascertained as clearly as practicable about the average Aveight of the patient when in normal health, the next thing is to endeavour by every possible means to recover that weight completely. Where the loss has been considerable, this may prove a most difiicult task, and when the loss has gone beyond a certain point, it may be quite impossible to recover the original weight. In very extreme cases of exhaustion and emaciation, wilh stomachs so irritable that nothing can be kept down, I have been able to put the first stop to the downward progress by mixing Pancreatic Emulsion with nutritive enemata, and it has been administered in this way till sufiicient restoration of strength and of digestive power lias been gained to allow of food and medicine being given by the mouth. And in cases where the stomach tolerates food and medicine, but in which the loss of weight has been very great, it is well to supplement the treatment by the stomach by extra doses of emulsion given in enemata; and thus to get a larger daily supply of fat into the system than the stomach could possibly take.* In this endeavour to restore the normal weight, * According to the cai-efiil estimate of Dr. Lyon Playfaii- ( The Food of Man ia Eelation to his Useful Work, 1865), the quantity of fat requii'ed by an adult in twenty- four hours, to keep up healthy nutrition, is from 1 oz. to 2-5 oz.; and according to the estimates made from very numerous and carefully-selected data by Mr. Farrants and myself ( On Diet and Regimen in Sickness and Health. Fifth edition. Lewis, Gower Street), the quantity is from 2 oz. to 3'5 oz. We may fairly assume, then, that not less than two ounces of fat per day, on an average, is required to keep up healthy nutri- tion in an adult. We have next to bear in mind, that before a case of consumption ordinarily attracts attention, and begins to be treated as such, many pounds weight, principally consisting of fat, have been gradually removed from the body. In this con- dition—1, a deficiency of fat throughout the organism; 2, a loss of the power to assimilate ordinary fata; 3, a constant demand for two oimces per day to maintain healthy nutrition,—we administer cod-liver oil, in the belief that this form of fat will assimilate when other forms will not. Supposing that it agrees, and that some or all of it is utilised, a rapid improvement takes place in the patient, from the supply of some of that for want of which life was steadily lading—very much as a cut flower that has drooped for want of its supply of sap, rallies and recovers freshness for a time when put into water. But there are very few persons who can take more than from half an ounce to one ounce of oil per day—few who can take even this steadily from week to week without intermissions. But supposing an ounce or an ounce and a half per day to bo taken regularly, how is this to supply, not only the two ounces per day required for healthy nutrition, but all the extra ounces of arrears that were lost before the treat- ment was begun ? But assuming the possibility of two ounces per day of oil for nutri-