Part 53

Diet.—Should be easily digested food. Milk is the most suitable. Dilute with alkaline or mineral water. Barley- or oatmeal-water and lemonade may be given. Broths and soups may be substituted for milk at times. Regular feedings every two hours until patient convalesces.

GOUT.

Gout is characterized by sudden attacks of severe pain in the smaller joints, especially that of the big toe. There is a gradual deposit of urate of sodium in and about the joints, and presence of uric acid in the blood.

=Causes.=—Intemperate living, excess in drinking wines and liquors, overindulgence in rich foods, change of climate.

=Treatment.=—Proper elimination. Free use of all kinds of mineral waters, abstention from alcoholic drinks and moderation in eating. Exercise by walking and living in the open air may counteract any hereditary tendency to the disease. Cold baths, followed by massage, may be given to the sthenic patient, while the warm and tepid bath should be substituted for the asthenic type. Protect the body from exposure to cold. Flannel underwear should be worn.

Diet.—Milk for liquid—no coffee or tea. Vegetables and fruit, excepting bananas, strawberries, tomatoes, oranges, lemons; fish, oysters and soup in small quantities; no fresh meat should be allowed for a time. Avoid hot breads, pastry of all kinds, spices and eggs.

DIABETES MELLITUS.

A disorder of nutrition, characterized by an accumulation of sugar in the blood, and excreted in the urine. The amount of urine is greatly increased, accompanied by progressive loss of flesh and strength.

=Treatment.=—Regulate diet, exercise and mode of living. A warm bath every other day and a Turkish bath every two weeks are very beneficial.

Diet.—Avoid sugar, starch and all liquors. Patient may eat soups without vegetables and flour; fish of all kinds; meats and fats cooked in any way except with flour; gluten bread. Of vegetables—lettuce, cucumbers, spinach, tomatoes, onions, celery, radishes, cauliflower, cabbage, egg-plant. Of desserts—custard, nuts, acid fruits, ice cream without sugar. Of drinks—coffee, tea and buttermilk, lemonade, beef-tea, chicken broth, and egg-nog.

Fluid diet must be moderate, and sugar and flour must not be used in any form.

BRIGHT’S DISEASE.

(Acute Nephritis; Inflammation of the Kidneys.)

=Due= to the action of cold or toxic agents upon the kidneys.

Causes.—Cold, poisons of specific fevers, toxic agents, pregnancy, blows and injuries of the back, lesions of the skin as in burns or in chronic skin diseases.

=Symptoms.=—Fever, pain in the back over the kidneys, nausea, vomiting, frequent desire to urinate, puffiness of the face, swelling of the ankles, extreme pallor of the skin, shortness of the breath, with the general appearance of complete exhaustion. The urine is very scanty and highly colored.

=Treatment.=—Rest in bed until all symptoms disappear. To promote activity of the skin and kidneys, alcohol or steam sweats should be given daily. To eliminate and purge the bowels give saline cathartics; and alkaline mineral waters may be used freely.

Diet.—Buttermilk, gruels made of barley or arrowroot, or oatmeal water; animal broths and oysters; substitute cream-of-tartar lemonade or plain lemonade for tea or coffee. Pure milk should be taken freely.

UREMIA.

Uremia occasionally develops during the course of acute or chronic Bright’s disease and other maladies, the result of the retention or accumulation in the blood of an excrementitious material, supposed to be urea, the flow of urine being either normal, lessened, or increased.

TREATMENT FOR TUBERCULOSIS.

Fresh air and sunshine, a rest in bed from one to three months, and proper food are the three vital points of importance. Do not give too many baths.

=Diet= should consist of starch foods—60 per cent. Stale bread and crackers may be prepared in variety. Give albuminoids and tender meats. Milk and eggs should be given about six times a day.

FOR PATIENT IN SITTING POSITION.

A contrivance easily made and very useful in nursing cases where the patient is to be kept in the semirecumbent or sitting position, as, for instance, in pneumonia, or in operations on the upper abdomen, is arranged by taking a broomstick with the broom part sawed off. Wrap around this stick a blanket, large pillow, or something to make it resemble a knee bolster. Place this under the knees of the patient, and to each end of the broomstick attach a stout cord, which may be securely tied to the bed-posts at the head of the bed. This will add to the comfort of the patient in preventing the constant sliding down which is so difficult to prevent. It will also save the nurse a great deal of tugging and lifting.

MISCELLANEUOS NOTES AND REMEDIES.

COLDS.

This was one of the subjects of discussion at one of the meetings of the New York State Medical Association.