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Page 33
When the full treatment has been reached, and kept up for a few days, I
begin to watch the urine with care, because if the patient be overfed
the renal secretion speedily betrays this result in the precipitation of
urates. When this occurs at all steadily, I usually give directions to
lessen the amount of food until the urine is again free from sediment.
Nearly always at some time in the progress of the case there are attacks
of dyspepsia, when it suffices to cut down the diet one-half, or to give
milk alone for a day or two. Diarrhoea is more rare, and has to be met
in like manner; or, if obstinate, it may be requisite to give the milk
boiled. Occasionally the rapid increase of blood is shown by nasal
hemorrhage, which needs no especial treatment.
Perhaps I shall make myself more clear if I now relate in full the
diet-list of some of my cases, and the mode of arranging it.
I take the following case as an illustration from my note-book:
Mrs. C., a New England woman, �t. 33, undertook, at the age of sixteen,
a severe course of mental labor, and within two years completed the
whole range of studies which, at the school she went to, were usually
spread over four years. An early marriage, three pregnancies, the last
two of which broke in upon the years of nursing, began at last to show
in loss of flesh and color. Meanwhile, she met with energy the
multiplied claims of a life full of sympathy for every form of trouble,
and, neglecting none of the duties of society or kinship, yet found time
for study and accomplishments. By and by she began to feel tired, and at
last gave way quite abruptly, ceased to menstruate five years before I
saw her, grew pale and feeble, and dropped in weight in six months from
one hundred and twenty-five pounds to ninety-five. Nature had at last
its revenge. Everything wearied her,--to eat, to drive, to read, to sew.
Walking became impossible, and, tied to her couch, she grew dyspeptic
and constipated. The asthenopia which is almost constantly seen in such
cases added to her trials, because reading had to be abandoned, and so
at last, despite unusual vigor of character, she gave way to utter
despair, and became at times emotional and morbid in her views of life.
After numberless forms of treatment had been used in vain, she came to
this city and passed into my care.
At this time she could not walk more than a few steps without flushing
and without a sense of painful tire. Her morning temperature was 97.5�
F., and her white corpuscles were perhaps a third too numerous. After
most careful examination, I could find no disease of any one organ, and
I therefore advised a resort to the treatment by rest, with full
confidence in the result.
In this single case I give the schedule of diet in full as a fair
example:
Mrs. C. remained in bed in entire repose. She was fed, and rose only for
the purpose of relieving the bladder or the rectum.
October 10.--Took one quart of milk in divided doses every two hours.
11th.--A cup of coffee on rising, and two quarts of milk given in
divided portions every two hours. A pill of aloes every night, which
answered for a few days.
12th to 15th.--Same diet. The dyspepsia by this time was relieved, and
she slept without her habitual dose of chloral. The pint of raw soup was
added in three portions on the 16th.
17th and 18th.--Same diet.
19th.--She took, on awaking at 7, coffee; at 7.30, a half-pint of milk;
and the same at 10 A.M., 12 M., 2, 4, 6, 8, and 10 P.M. The soup at 11,
5, and 9.
23d.--She took for breakfast an egg and bread-and-butter; and two days
later (25th) dinner was added, and also iron.
On the 28th this was the schedule:
On waking, coffee at 7. At 8, iron and malt. Breakfast, a chop,
bread-and-butter; of milk, a tumbler and a half. At 11, soup. At 2, iron
and malt. Dinner, closing with milk, one or two tumblers. The dinner
consisted of anything she liked, and with it she took about six ounces
of burgundy or dry champagne. At 4, soup. At 7, malt, iron,
bread-and-butter, and usually some fruit, and commonly two glasses of
milk. At 9, soup; and at 10 her aloe pill. At 12 M., massage occupied an
hour. At 4.30 P.M., electricity was used for an hour in the manner which
I have described.
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