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J. O. Stillson, M. D., Indianapolis, "Removal of the Middle Turbinate for the Cure of Some Forms of Inveterate Eye Dis. ease.” The author read a very interesting paper upon this subject, in which he reported his observations as to the relationship of nasal and eye diseases and the results he had obtained in allay. ing eye symptoms by the treatment of nasal conditions, more eg. pecially the removal of the turbinate.
Dr. Goldstein, as chairman of the local Committee of Arrangements, arranged for a museum of pathologic and anatomic specimens, which, while not large, was extremely interesting and marks a new departure in this society.
The officers elected for the ensuing year were as follows:
Dr. C. R. Holmes of Cincinnati was made chairman of the local Committee of Arrangements for the meeting to be held in Cincinnati next year.
Dr. Loeb of St. Louis, chairman of the Membership Committee.
THE TREATMENT OF URIC ACID POISONING
With CLINICAL REPORTS.
By ROBERT C. KENNER, A.M., M.D.,
It is commonly thought that gout, as it is seen in England, is not frequent in this country. Yet, the doctor who has seen much practice, cannot deny that the manifestation of the poison which causes gout is very common indeed. In my practice, covering twenty-two years, I am prepared to say that uric acid poi. soning is one of the most common affections I am called upon to treat. I can also add that it gives more discomfort than most dis2999 oonditio
In treating patients who have uric acid poisoning there are two indications—the first comprises atttention to the patient's dietary, and the second comprehends the administration of such remedies as will neutralize and remove the uric acid, and which will stimulate to proper activity the liver, which is usually in a torpid condition in these cases.
In carrying out the dietary indications we must tell our patient that the following foods are allowed: Fresh boiled fish, and clear vegetable soups, raw oysters, fat bacon, boiled or broiled chicken, game, sweet bread (in a sparing manner), cracked wheat, oatmeal, rice, sago, hominy, whole wheat bread or biscuit, rye bread, graham bread or rolls, crackers, dry toast, milk toast, macaroni, mashed potatoes, green peas, string beans, spinach, cabbage, cucumbers, cresses, lettuce, celery, plain milk pudding, rice and milk, sago and milk, stewed fruits, all without any sugar, milk, buttermilk, toast water, pure water, cold or hot.
The following foods must be avoided. These are: veal, pork, goose, duck, turkey, salted, dried, potted or preserved fish or meat, except fat bacon, eels, mackerel, crabs, salmon, lobsters, eggs, rich soups, gravies, patties, tomatoes, sweet potatoes, asparagus, peas, beans, mushrooms, rhubarb, lemons, pickles, vinegar, fried or made dishes, rich puddings, spices, pies, pastry, sweets, cheese, nuts, dried fruits, tobacco coffee, cider, malt liquors, sweet wines and champagne.
I have given this list somewhat at length because I have thought it important to have the patient begin with a correct diet. The diet must be persisted in for a protracted period, and there must be no relaxing in the patient's adherence to the correct diet.
The drug treatment of uric acid poisoning is most important and we shall make no substantial progress toward a cure unless proper treatment is instituted.
Examination of the various works on therapeutics and practice will show that the lithia salts have formed and maintained the greatest degree of popularity with the most practical men in the profession. Lithium has brought me good results, but it has often been found wanting because it has not in itself been capable of arousing in any way the torpid state of the liver, nor, as found commonly in the market, quickly and easily taken into the system. This fault has by the aid of advanced pharmacy been corrected by the bringing out of a laxative salt of lithia, thialion. This salt of lithia acts as an hepatic stimulant and at the same time has proven itself superior as a solvent and eliminant of uric acid. Thialion acting as an hepatic stimulant and laxative at once relieves the constipation which is almost an invariable accompaniment of all types of uric acid poisoning. I begin with thialion by giving it in doses of a teaspoonful in hot water three times daily.
After one or two days I frequently have the patient take a dose only night and morning. In this matter of dosage I gener. ally feel my way-if needs be, I give four teaspoonsful daily, but if the bowels are kept loose two teaspoonfuls daily will often be all that is required and often one will suffice taken last thing at night or the first thing in the morning on rising. Always in water as hot as can be drunk.
The physician must be governed by the case in hand in the matter of dosage.
The following briefly told cases, illustrate the treatment here advocated:
Case 1—This man was a hotel keeper and an epicure, and indulged himself freely in those foods and drinks which stand in a caustive relation to uric acid poisoning. He had all the symptoms of lithæmia and had been confined for the last few days with swelling in the shoulder joint and pain in both arms. Along with this was constipation and a furred tongue. He was put on thialion, teaspoonful four times daily, and this was changed to three teaspoonfuls, and later to two teaspoonfuls daily. His diet was corrected on the lines already laid down.
His improvement was noticeable on the third day, and after that there was a speedy disappearance of his pain and swelling, and he soon resumed his business. He observed the dietary restrictions and took the thialion for six weeks, and has not suf fered since, and his general health is now most excellent.
This patient had been a sufferer for some time with vertigo. From the second day of treatment he began to suffer less with this symptom, and now has been exempt for some months.
Not only in this case, but in other cases, has vertigo disappeared under the employment of thialion.
Case 2.—This patient was a chronic sufferer with indigestion, biliousness and diffused pains. When I was called her feet were swelled and she suffered a great deal of pain. On thialion this woman ceased to have biliousness and indigestion, and her improvement was rapid from the second day of treatment. After taking the thialion for several weeks she says her health has never been so good.
Before taking thialion this woman had not been able to use her left arm without considerable pain for nearly two years. Either her wrist or the elbow joint would be swollen nearly all the time.
Since the time she began employing this remedy this state of swelling and pain has subsided.
Case 3.—This was a gentleman who took insufficient exercise and ate the most delicate and stimulating foods. He had well marked symptoms of uric acid poisoning. I had him live up to a rational diet and to take thialion with regularity. This cours
had the happiest effect upon him and he made steady progress towards a permanent cure.
Seen a few days ago, this patient says he has a clear head, his bowels act freely and he never was so free from pain in the last five years.
Consideration for time and space will not permit me to go further in giving slinical histories; these, it is believed, make it clear that the treatment here advocated is the most promising one in this affection.
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