N. M. DEWEES, M. D
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Mrs. S. applied at my office for treatment Sept. 26, 1905. She was a large woman weighing 185, age 46 and childless. She complained of palpitation, shortness of breath, nervousness, and despondency. Appetite poor, having a decided distaste for bread; was thirsty, drinking a large quantity of water; was obliged to get up several times during the night to micturate; skin dry and harsh; mouth dry, tongue furred. The white of the eyes was muddy and the complexion was sallow; constipated; complained of intolerable itching of the vulva and skin on the inner side of thighs. I told her to ascertain the amount of urine voided during twenty-four hours and to bring me a sample for examination.
I prescribed as follows:
|Specific cactus||drs. 1.5|
|Specific pulsatilla||drs. .5|
Mix. Sig.: A teaspoonful every three hours.
Also Rx Elixir podophyllum.
Teaspoonful before meals until bowels should act, then a teaspoonful at bedtime.
I prescribed libradol for the itching, which gave entire satisfaction.
The patient returned in a week with the heart function improved. She was less nervous and despondent, the bowels were better and she was much improved all around. She said she passed more than two gallons of urine in twenty-four hours—an incredible amount it seemed to me. The specific gravity of the sample brought was 1036, with Fehling's sugar test it gave a strong reaction for sugar. I prescribed this time:
|Specific rhus aromatica||oz. .5|
|Glycerine q. s||oz. 5.5|
Mix. Sig.: Take a teaspoonful every 3 hours. The elixir of podophyllum was to be continued as before.
As I had tried dieting other patients in this condition before, without much benefit, I concluded to take a hint dropped by Professor Lloyd in a lecture before the class of E. M. I., 1892. He said he did not see the advantage of withholding bananas from diabetics as sugar would be made in the liver anyway. I told her to eat what she wanted, but suggested meat, buttermilk, cheese and tomatoes.
Her condition began to improve at once and continued to do so for ten weeks, at the end of which time the quantity of urine voided in twenty-four hours was less than four pints. There was no trace of sugar in the urine and the patient was discharged. There has been no recurrence of disturbance to date.
The elixir podophyllum mentioned above I prepare as follows:
Fill a vessel with recent dried root, cover with 80 per cent alcohol, let stand for three weeks. Pour off the tincture, and of this add 20 ounces to sufficient quantity of simple elixir to make one gallon. Shake and let it stand for two or three days before using. The maximum dose of this is a teaspoonful.
COMMENT:—The doctor has had better success with a simple course of treatment in this case than physicians generally have. He is to be congratulated. Rhus aromatica has been used for a number of years in the treatment of diabetes. In a few cases the results have been satisfactory, but we have not been able to determine as yet, the particular class of cases, nor the exact indications for which this agent is curative. Further observations are required.
Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.