Vol. 60, 1909 - University of North Carolina at Chapel Hill

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The Charlotte Medical Journal
Vol. LX CHARLOTTE, N. C, DECEMBER, 1909.
j breakfast of one roll and one and a half
i glasses
( ed by tube one hour after ingestion. The
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I acidity,
Results of Stomach Analyses in hands and wrists in the
Pellagra.*
following August.
An analysis at this time gave; HCI, 4; total
By Dr. W. O. Nisbet, Charlotte, N. C. acidity, 28; mucus, no excess; bile absent;
T desire to report results of the motility,
analyses
normal. Patient still living.
of stomach contents of ten cases of pellagra. Case 4.— j. E., adult male, age 31; na-
All of the cases were given the tive
Ewald-Boas of N. C. History of mild alcoholism
and of spring dia.rhoeal attacks for several
of water, and contents were removyears;
mouth, stomach, bowel and cord
signs present when seen in August, 1908.
acidity was estimated by Topfer's method Analysis; HCI, 8; total acidity, 33; mucus,
titration. A detailed account of
in
the cases
excess, ferments, diminished; motility,
will not be given; only the stage of the disease
and the points bearing on the stomach
secretion will be mentioned. My experience
is limited to twenty-five cases of pellagra,
and in only ten of this twenty-five did
I succeed in getting test meals.
Case 1.— Miss W., native of Alabama,
age_29. History of diarrhoea in spring of
19n7. I saw patient first in September,
19u8, and found pre.sent hand and wrist
eczema, bald tongue, burning in stomach
and diarrhoea, ana! excoriations, slow mental
action, despondency, but with reflexes
about normal; emaciation to an extreme
degree. Only one test was made of stom-
acli contents and showed HCI, 0; total
50; ferments not estimated; mucus
f in excess. Hile was present during the
I periods of severe vomiting. Motility not
tested. Patient died October, 1908.
C.VSE 2.— .Miss C. age 26; native of S. C.
First seen in September, 190S; gastro-intestinal
and mental symptoms marked and
eczema beginning on knuekles. Patient
gave history of sore mouth, nausea and
diarrhfca in the spring of the preceding
year. Analysis of stomach contents; HCI,
4; totol acidity, 28; mucus, in excess; ferments,
coagulation of milk delayed. Motility
not tested. History of presence of
bile during severe vomiting, Died six weeks
later.
Cask .5.— Mrs. R,, age .3.5; native of S. C.
Flad been very neruous for twelve months,
and had raw mouth and tongue in the past
spring, Saw first August, 1W8, and presented
characteristic gastrointestinal signs
with staggering gait, but no hand eczema;
analysis stomach contents; HCI, .i.S; total
acidity, 80; ferments, normal; mucus,
no excess. 'JMiis patient got better
during winter, but had a return of symp
tonisthe following April; still no hand erup
tion. At this time a second stomach analysis
showed; HCI, 10; total acidity, 40; mucus,
no excess. The eczema appealed on
*Read before the I'ellagra Conference held in
Columbia, R. C, recently.
normal ; bile present during periods of vomiting.
There was improvement during winter,
but in May symptoms returned in increased
severity and with the presence of
the typical eczema of hands, arms and
elbows. Analysis at this time gave the
following: HCI, 0; total acidity, 24; mucus
in excess; motility, normal. Patient
died the following September.
Case ,S.— Mrs. W., age 36; native of
N. C. Eczema and gastrointestinal symp-,
toms, marked; locomotion and reflexes,
normal; mental action, sluggish. Result
of analysis HCI, 4; total acidity, 18; mucus,
no excess; motility, normal; ferments, normal.
Patient improved under arsenic but
had a mild recurrence the following spring.
Case 6.—Mrs. P., age 34; native of
N. C. Gastro-iiilestinal symptoms, with
insomnia and vertigo appeared in fall of
1908. Analysis at this time gave HCI, 24;
total acidity, 56; ferments, normal; motility,
normal; mucus, excess. In June, 1908, the
above mentioned symptoms returned in
acute form along with decided hand eruption.
Specimen of contents at this time
gave no reaction for HCI, but there was
excess of mucus. Patient died six weeks
later.
Case 7.— Mrs. K., age ,58; native of
N. C. Sore mouth, burning stomach and
periodical diarrhoea appeared in September,
1907. Analysis at this time gave HCI, 39;
total acidity, 76; mucus, not in excess;
motility, normal. Patient improved under
arsenic and cold weather, but in .\pril had
a return of symptoms, with the appearance
of hand eruption in addition. Analysis;
HCI, 20; total acidity, 42; mucus, no excess;
motility, normal. A third analysis
in October gave result; HCI, 8; total acidity,
22; mucus, in excess; motility, normal.
Case 8.— Mrs. M., age 37; native of
N. C. Sore mouth and gastro-intestinal
signs first appeared in April, 1909. Insomnia
and despondency for two years. In
August, in addition to above symptoms,
began to walk unsteadily and noted also
the appearance of "sunburn" on knuckles