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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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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    The usual defect in primary digestion witli such patients, is the com- bination of an excess of acidity with a feeble stomach, and this should be corrected by an effervescing draught of potass and soda, with citric acid, quinine and strychnia; or, where there is much flatulent distension as well as epigastric pain soon after food, by a stomachic powder of bicarbonate of soda, bicarbonate of potass, powdered ginger, and powdered calumba, in half a tumbler of water, a quarter of an hour before the meal. At the same time it is frequently necessary to unload the bowels, and to relieve the portal system, which has often been long over- loaded with cod oil olein, absorbed by the veins. It is to be remem- bered, as I pointed out in 1867,* that whereas olein is, in some measure at least, taken up by venous absorption ; the solid fats have to pass by the lacteal route ; and thus, when substituted for oil, in the form of pancreatic emulsion, they relieve the tax upon the choked-up venous system. Then, the period after a meal at which the emulsion is taken may be varied, to meet the differences in the rapidity with which different stomachs dispose of their contents. Many who cannot keep the emulsion comfortably down when taken two hours after food, can do so if they take it from half an hour to an hour after. This parti- cularly applies to young children. They generally manage it best within half an hour of a meal ; and when their diet consists of farin- aceous foods and milk it is best to mix it with a portion of the food. With regard to menstruum :—milk is certainly the nicest and best, where milk agrees with the stomach and taste; but many persons have an old-standing aversion to milk, or have long ceased to be able to digest it comfortably. In such cases it is absurd to insist on the emulsion being taken in milk. The best substitute, and indeed one of the best menstrua for Pancreatic Emulsion, is thin water-arrow- root. The emulsion mixes well with it, and by converting the starch into glucose, gives it a pleasant, nutty sweetness. Many persons, however, prefer the emulsion mixed in water to about the consistence of new milk and then flavoured with wine, especially Tokay, ginger Avine, or orange wine. In whatever menstruum it is mixed, it should not be made much thicker than new milk, and I advise a sufii- cient quantity of wine, brandy, rum, orange-brandy, ginger-brandy or clove-brandy, to be added, to give it a decidedly cordial character both to the palate and to the stomach. One of the most important points in getting the emulsion well taken, is to have it smoothly mixed in the menstruum; this is easily done by putting the emulsion first into the cup, or glass, and then adding the menstruum little by little, and beating together with a spoon, till the whole is made of about the consistence of oil, or of good cream; after which, any quantity of fluid may be mixed by simple stirring ; but if the emulsion is put in a lump into the menstruum, it may be difficult * On the True Fii'st Stage of Consumption. Lectures delivered at the Eoyal Hospi- tal for Diseases of the Chest.—CirrncHTLL. I