Improvements in Dietetics of Diabetics
Authors: J. Sawyer
Journal: BMJ (1904)

DIET IN DIABETES.[4 537in later years could hardly walk at all, when firat examined was of a dark-blue colour, both in face and fingers.Ozn departure the dark-blue colour had in a great measure disappeared, and the swelling of the liver had distinctly dininished.At the e4d,f the cure the patient was able to take short walks of fifteen to twpnty minutes,.andeven to make without difficulty the slight ascent of tep, minutes from my house to her dwelling, whereas at first she had to be wheeled up in a bath chair.CASE VII.Graves's Disease; Myocarditis: Severe Anaemia.-Mrs.A., aged 45.The patient had taken iron and digitalis before her stay at Nauheim.A short time after her arrival she had right-sided pul- monary infarct (embolism).She continued the digitalis for three days, and later for a short time took haematicum (Glausch) three bottles.May 26th.After the fifth bath (first measurement), haemoglobin 58 per cent (blood pressure 95 mm.Hg.).July 8th.After the thirty-second bath (of which ten sprudel baths), haemoglobin 69-70 per cent.(blood pressure xI5 mm.Hg.).CASE VIII.Myocarditis Due to Abuse of Alcohol and Tobacco; Dilatation of both Ventricles, chiefly of the Left; Paroxysmal Tachycardia.-Mr.F., aged 54.July 8th.Before the first bath, haemoglobin 65 per cent.(blood, pres- sure 115 mm.Hg.).August 28th.After the thirty-second bath, haemoglobin 85 per cent.(blood pressure 135 mm.Hg.).CASE IX.Mitral Insufficiency and Stenosis; Chronic lNephritis.-Mr.0., aged 22. May 20th.Before the first bath, haemoglobin 68 per cent.(blood pressure 85 mm.Hg.).June 4th.After the ninth bath, haemoglobln 75 per cent.June xsth.After the skteenth bath, haemoglobin 76 per cent.June 24th.After the twenty-first bath, haemoglobin 8i per cent.July 4th.After the twenty-seventh bath (ten of which were thermal- sprudel baths), haemoglobin 82 per cent.(blood pressure 120 mm.Hg. ).The patient, who took no medicine, and at first was very pale, looked blooming in the end, and could walk without the slightest difficulty for hours.These few cases described here show that the treatment by baths and gymnastics is capable of increasing the formerly depreciated haemoglobin in cases of heart affection, be they cases of weakness of the heart muscle or valvulfar diseases (simple or complicated), Graves's disease, or chronic myocard- itis, with or without kidney disease.Naturally there were many cases in which this increase was only very slight.According to my observations it seems far easier to raise the amount of haemoglobin in young and middle-aged persons than in those of riper years.Even if these latter feel much better after following the treatment, there is frequently no change to be seen in the amount of haemoglobin.The fol- lowing is an example of this: CASE X. Chronic .Myocardcltis; Severe Arteriosclerosis; Angina Pectoris Bradyeardia (pulse 30-36).-Mr.L., aged 68.May 20th.Before the first bath, haemoglobin 79-80 per cent.(blood pressure I6o mm.Hg.).May 29th.After the seventh bath, haemoglobin 8o per cent.June 17th.After the twenty-first bath, haemoglobin 79 per cent.(blood pressure 150 mm.Hg.).During the last part of the cure duplicated heart beats were some-, times noticed, but only on auscultation; not in the radial pulse.Very often there were 54 heart beats, with a radial pulse of 30 to 36.Very instructive for medical men are these cases in which, during the treatment, a diminution of the haemoglobin is ob- served; and let it here be noted that severe physical over- exertion and violent emotional disturbances, especially in febrile diseases, in a short time rapidly produce a diminution in the haemoglobin.Of this, in conclusion, one example: CASE XI.Weak Heart: Dilatation of Both Ventricles.-Mr.S., aged 44.He had severe anaemia, for which for many years iron had been taken at home.May igth.After the first bath, haemoglobin 70 per cent.(blood pressure 230 mm.Hg.).June 2nd.After the tenth bath, haemoglobin 85 per cent.June 22nd.After the twenty-fifth bath, haemoglobin 8o per cent.The patient suffered from feverish bronchitis and had undergone severe physical exertion during a several days' journey.June 23rd.After the twenty-fifth bath, haemoglobin 79 per cent.(blood pressure xio mm.Hg.).During the following eight days the haemoglobin rose gradually again to 85 per cent.and the blood pressure to 130 mm.Hg.