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

370
THE CHARLOTTE MEDICAL JOURNAL.
composition as that derived from animals, results will be more or less pronounced as
The infective decomposition of the nitro- the trouble is more or less acute and progenous
portion of our foods (either before longed.
or after ingestion) results in the fotmation In April, 1904, I began keeping brief
of leucins, ptomaines, etc. These, when records of cases. About a year ago, the
taken into the stomach, produce high tem- frequency with which the word pyrosis" i
peratures running from 104 to 11.5 F. It appeared in my notes attracted attention, i
is usually an acute process and the high The meaning of the term "pyrosis" in my
j
temperature suspends vital functions, unless mind was the eructation of air or fluid from
quickly relieved. Chronic incomplete oxi- the stomach to the mouth of more or less
'
dation'of nitrogen tends to inflammation of
fibrous structures of joints, aponeuroses beacid
reaction, and cardialgia, due to rancid
and volatile acids in the stomach and
,,
ji
tween muscular layers, and of the heart duodenum. This definition resulted from
and lungs. Also to troubles with the kid- a long continued personal suffering with
neys and arteries, and the optic nerve, these symptoms about forty years ago, m |!
terminating in hopeless, helpless, arthritis spite of varied combinations of medical .
deformans. The defective digestion and talent and remedies used at that time. The ;i
assimilation of starch results in an use of these words was steadily increasing ';
acetous fermentation, with its attendant in my records. I, with many others, attend- |i
distention of the digestive canal with ed the first pellagra conference held in Co- <
gases sweet or slightly acid, with slight lumbia a year ago. We inspected the nu-
disturbances of temperature, colics, etc., merous patients present. They were all in j|
of slight importance, unless it becomes the advanced stages of the disease, and 1
chronic and terminates in diabetes, or every one will recall the helplessness and ;
other troubles of that kind, and skin in- hopelessness presented by them. I had been i
volvements of carbuncle and furunculosis. taught that the eruption ou the posterior 'i
It is usually easily remedied, unless mixed surfaces of the forearm and hand, nearly ]
with a rancid decomposition of the fats, symmetrical, was the initial symptom, which ^j
which soon overshadows it, and controls appears to be the generally accepted con- •the
situation. To mv mind, the products elusion at the present time, although pellaof
starch decomposition are not as apt to gra without the eruption is mentioned. This ;;
contaminate the fat contents of food as vice initial symptom had never yet appeared m ,
versa. When rancid fat gets into the stom- my work. September 7, 1909, it came in
j
ach the conditions become exceedingly what I called "my awakening case." It
^
troublesome. The complete and permanent was of Mrs. S., aged 30, white, blonde,
removal of the resulting volatile fatty acids married, mother of four children, last con- i
is a task requiring time, patience, reflexion, finement four years ago. She had been i
and pure remedies well handled and a dizzy six months, pains in upper, left ant. ^i
proper diet, and recurrences or relapses are thorax, going to shoulders and arms, and ;i
frequent and long continued. The fatty in throat, fair appetite, costive, slight fever,
acids resulting from the germ destruction "pyrosis," salivated (not Hyd.) high col-
of fats are oleic, stearic, magaric, but the ored urine, frequent dysuria, last period |<
vo/a/i/c fatty acids, of which there are nine three weeks ago, three days, no pains or j
derived from fats and oils, headed by distress, diarrhceic attacks at times, roaring ,i:
Butyric acid, which saturate the body and in the ears, mental confusion, dry scaly ':
its fluids like chloroform and ether, are of eruptions on lower two thirds of backs of (
first importance, and must result in lessened forearms and hands, to the metacarpopha- jd
alkalinity of the body generally. In Brande langeal joints. This has appeared "\the .(
and Taylor's Chemistry, published about same location three or four times. The jl
187.5, a' short note mentions the ingestion, skin at site of eruption is decidedly darker )
by Dr. Lared, of Butyric. acid, experiment- than elsewhere on the body. She does ,
ally with the incident production of pyrosis housework, is not out in the sunlight, has ;i
been in bed six or eight weeks and lives on ,:
and'cardialgia.
I wish particularly to draw vour attention corn. She has severe pains in back ot head ,<
to these svmptoms produced by this experi- and neck, the muscles of which seem stiff |f
ment as'l think they are prominent symp- and act slowly, with pain. The pupils were JM
toms 'found in the early stages of pellagra, moderately contracted. She has lost about 1
A condition resulting should be one of de- forty pounds in weight in the last two or j.^
cidedly reduced alkalinity of all the solids three years. The pulse rate is /6: 1 . 9.S6 10; ;>1
and fluids of the body. This is shown by Sphyg. 100. She is sahvated {not mer-j^
the fact that all these patients were free curial) and markedly depressed. She has,i
users of bicarbonate of soda, self prescribed, steady "burning" in stomach, throat and |i
in spite of their expressed fear that its use mouth. In the latter two cavities thCja
tended to "eat out the stomach." These mucous membrane is intensely
4. A^A („ n«..,f .^,.1 fiia ct/^tTid^li " Thf^cp Tiiiicniis membrane is intensely red. II
j
}
J
j
j