The Health bulletin [serial] - University of North Carolina at Chapel Hill

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: 32 The Health Bulletin September, 192: sore mouth is a terrific diarrlioea. Consequently an insufficient amount of fluid is swallowed and a great excess of fluid is lost in the loose bowels. The result of this deficiency of body fluids is known as dehydration, and makes one of the emergencies of medicine. Doubtless in the past many cases of i)ellagra were lost by this complication. With this there is often added grave vomiting. Examination of the urine will show a marked reaction for diacetic acid with ferric chloride indicating an acidosis. The whole condition can be largely controlled by the judicious use of a ten per cent solution of glucose in normal salt solution given intravenously in amounts from 200 cc. to 400 cc. The solution must be kept at a sutSciently high temperature and given very slowly. Sometimes even the Murphy drip speed of administration is desirable. The heart muscle in pellagra is usually gravely damaged in this type of case, and it should be shielded from every possible strain. Sudden death in such cases is by no means unusual. Recently it has been demonstrated that in many of the severely sore mouths the infection known as Vincent's angina plays an important part in its correction by arsphenamine locally in glycerine and intravenously plays an important part in relief of suffering, making the taking of food easier, and thereby reducing the danger to life. Tlie intravenous dose should be very small at the start at least. In this connection it is well to mention the use of arsenical preparations intravenously especially of cacoadylate of soda so much in vogue at this time. My experience is that except for the tonic effect there is nothing to expect from such treatment. There is always the possibility of an arsenical neuritis to be considered, and it is likely that the dose will be greatly increased because no decided result will be obtained, and in the end the drug may become an added source of suffering. We are dealing with a food deficiency, and it seems unwise in the extreme to befog the main issue by giving drugs for a condition which calls for food. In this disease, at least, it is high time for the medical profession to cease giving drugs to satisfy the family and the patient when he knows full well no good can come therefrom. Far better to take those interested into his confidence and explain that food, and only food in great excess of the part which has been left out will accomplish anything. If the patient and her friends know that only by way of food can recovery come the number of patients cooperating will be greatly increased. Finally, after a patient has recovered from an attack of pellagra, it should be made perfectly clear that a recurrence in the following spring will be entirely unnecessary, provided the errors of the past are not resumed. Many go back to their evil ways as "a fool returueth to his folly." These are cases who suffer the yearly recurrence gradually growing worse until their mental state necessitates their being committed to a hospital for the insane. In my opinion practically every case of pellagrous insanity at this time is preventable. Fur- , ther than this it can now be said with all confidence that every case of pellagra is preventable. In the future when the disease occurs it is somebody's fault, and that fault may fall on the teacher whether it be from the medical profession or the social worker or any other informed person who withholds this simple information. OUT OF THE MOUTHS OP BABES Agnes, aged five, was called in from play to breakfast. When her mother told her to wash her hands and face, she replied, "All right, mama, I'll wash my hands, but I've washed my face once, and I haven't used it any since." —From Children, The Magazine for Parents. As Betty, aged six, returned from school one afternoon, her mother asked "And what did my little girl learn at school today" Betty looked surprised, and exclaimed, "Oh, mother, do I have to educate you all over again"—From Children, The Magazine for Parents.
Bulletin will be -sent free to arwj citizen of the 5tcrteupoATequesi| Entered as second-class matter at postofRce at Raleigh, N. C, under Act of July 16, 1894, Published monthly at the office of the Secretary of the Board, Raleigh, X. C. Vol. XLH OCTOBER, 1927 Xo. 10 4 '^ ^^v^^ ^W"^ Ll.ît. ' JC^ In fhe Nantahalas, near the western end of North Carolina's five hundred and seventy mile long Broadway, where "All day long the sunlight seems As if it lit a land of dreams."
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I PUBLI5MLD ; BY TML. nOR,T/-\ CAgO
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January, 192'i The Health Bulletin
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January, 192''i The Health Bulletin
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j Th)5 B iillelirvwillbe -serxlfree
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Vol. XLII MARCH, 1927 No. 3 DIPHTHE
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Vol. XLII MAY% 1927 No. 5 EIGHTY TH
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Vol. XLII JUNE, 1927 No. 6 PURE DRI
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• President's address before the
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Vol. XLII AUGUST, 1927 No. « PARKS
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h Auoust. 1927 Trie Health Bulletin
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August. 191. The Health Bulletin 11
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