Cases Illustrating the Antiseptic and Antipyretic Treatment of Phthisis
Authors: W. H. Spencer
Journal: BMJ (1888)

increm an' exteads forwards and downwards to the groin and tea.tidcle.The stomach now frequently sympathises, amd there is either absolute nausea or at least inability to take food.The tongue is much furred: there is thirst: the pulse is full, strong, and usually accelerated.There is a tendency to drowsiness and head(lache.In conjunction with the.e symptoms the patient complains of a constant desire to pass his urine, which is scanty, highly coloured, extremely acid, and often loaded with bile.Under these circumstances the urinary symptoms sometimes increase to a great degree of severity, only small quantities of urine being excreted at a time, and the colicky symptoms strongly resembling those of renal calculus, being decidedly pronounced-and yet under careful treatment-when the medical attendant and the patient have come to the conclusion that the syrmptoms are due to renal calculus, and to renal calculus alone; they clear up and give no further trouble.A patient exhibiting similar symptoms came nnder my care last smmer.Early in March Dr. Allt, of Clapham, advisedl a gentleman, aged 47, to consult me, as it was feared that premonitory symptoms of diabetes were making their appearance, that is, the amount of urinary water was increased and the specific gravity considerably above the average, though no sugar was present.The patient had lost flesh, and his appetite was capricious.He had formerly led an active life, riding many miles daily, but since he had left the country he had taken to driving in a closel carriage, took little or no walking exercise, whilst his social popularity being great, he was in demand for dinner patties and other functions that led him ia the way of more eating and drinking than was good for a man of his habit and constitution, and which was also against his natural inclination, which was for plain and simple food.During the two years he had been in London his health had certainly failed him, and the attack in March was undoubtedly premonitory of something more serious.I prescribed mineral acids anud Carlsbad salts, and advised a less nitro.genised diet than he had been taking.Under this treatment he seemed to be doing well, when one day he took a long drive outside a coach to St. Albans and back.The day happened to be cold, with a north.eastwind.On his return he felt chilly, with general malaise ac- companied by severe lumbar pain; the next day he took a Turkish bath, in which he happened unfortunately to slip; this seemed to increase the pain in the back, which gradually localised itself in the left kidney.When I saw him the next day in consultation with Dr.Allt, he had a lquick pulse.a foul tongue, obstinate constipation, constant nausea, often actual retching, scanty, highly.coloured,acid urine, with intense renal pain on the left side shooting down into the left inguinal region.For some days the pains increased in severity and the symptoms were decidedly aggravated, and the ]ate Dr. Wilson Fox was added to our consultation.He held strongly for the view of renal calculus, and though I was rather biassed that way myself, still, remembering Prout's description, I had hopes that with due