Community Development: Information on the Efforts by the City of Philadelphia, Pennsylvania

This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1921 edition. Excerpt: ... for a milk diet. Meat extracts should usually be avoided. Attacks of diarrhoea started by cellulose (as a raw apple), and alternating with constipation, are attributed by Dr. H. H. Ellis to an early form of intestinal tubercle (see p. 264). Diet in Diabetes. The combination of diabetes with pulmonary tubercle is very difficult to treat successfully. In uncomplicated diabetes a strict antiglycosuric diet is likely to defeat its own objects and to increase the danger of acetone poisoning; in diabetes with tubercle a compromise is still more needed. Diabetes includes two different types of disease, in one of which the sugar excreted is less in quantity than the equivalent of starch in the food taken; whereas in the other and graver type, more sugar is excreted than can be so accounted for. In the slighter group it is usually safe to give as much carbohydrate food as corresponds with the difference between ingested and excreted carbohydrate, estimated with an ordinary diet. According to von Noorden, it is seldom advisable to reduce the quantity of carbohydrate in the food below 50 grammes per day in a patient of average weight. To provide sufhcient calories, the proportion of fat and meat must be increased. If the fats are much increased, there is some danger of acetonzemia, and the urine should be tested regularly with the ferric chloride test. The disintegration of proteins helps to neutralize the acidity; but if more meat is given than can be dealt with, the tendency to acidity is again increased. For this reason it is not advisable to increase the daily meat ration beyond 310 to 340 grammes (II or I2 ounces). In every case associated with wasting or with tubercle, an attempt should be made to estimate the relative dangers of the two...