Further observations on the use of pancreatic emulsion and pancreatine, in consumption, marasmus, tabes mesenterica, and other wasting diseases of children and adults / by Dr. Dobell.

Dobell, Horace Benge, 1828-1917.

Date:: [1874]

Credit: Further observations on the use of pancreatic emulsion and pancreatine, in consumption, marasmus, tabes mesenterica, and other wasting diseases of children and adults / by Dr. Dobell. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

10/16 page 10

$the influence of exercise and of temperature must always be kept be- fore the mind; a certain amount of exercise and a certain coldness of temperature may be essential to keeping up the appetite and digestion, without which no progress can be made with the feeding and fatten- ing process; but all exercise involves waste, and all cold involves waste ; therefore, so long as the weight of the patient is in any degree below the normal average, exercise and cold must be kept at the lowest point consistent with maintaining appetite and digestion.* A little over-fatigue every day may entirely frustrate all attempts to recover weight, and a little excess of demand for heat-producing materials to maintain the temperature of the body may just consume all the little surplus we are sending into the blood. Here lie our great difficulties in the restoration of weight, the rocks upon which so many promising cases are “ wrecked in port.” ON THE USE OF PANCREATIC EMULSION IN THE WASTING DISEASES OF CHILDREN. [From the “ Practitioner,” October, 1872.) The very interesting article by Dr. Prospero Sonsino, of Pisa, in the September number of the “ Practitioner,” “ On the Physiological Dyspepsia for Starchy Food in Infancy,” revives an intention, from which I have been diverted by other occupations, of publishing a few words on an allied subject. In the annual announcements of the medical journals for 1871, my name was put down for an article “ On the Use of Pancreatic Emulsion in Tabes Mesenterica,” and, had I tion, and another two ounces for arrears, being taken and utilised, even then the tchole thing may he unstable and may break down, (ion\ the fact that we are supplying oil and not solid fat—a body rich in olein and poor in stearin and inargarin, in the place of bodies rich in stearin and margarin and poor in olein, such as the fats taken in normal food. The practical conclusion from these considerations appears to he, that if we are to give a fair chance of recovery to a patient deprived of the natural powers of digesting and assimilating fats, we must, by one means or another, secure that two ounces of fat of average solidity aro utilised every day for the purposes of nutrition, and an additional ounce or two to make up for arrears. To obtain this end four principal means are now at our command : — 1st. The administration of as much oil and fat, either as medicine or food, as the digestive and assimilativo powers are still competent to utilise. 2nd. The introduction of fat and oil into the system by rubbing them into the skin of the body and limbs. 3rd. The supply of saccharine and amylaceous articles of food in sufficient quantity to insure that no call shall bo made upon the hydro-carbons for elements which can be as well supplied by the carbo-hydrates. 4th. Tho introduction of pancreatic emulsion and pancreatine, in sufficient quantities to enablo the digestive and assimilative organs to utilise tho necessary amount of fat (“On Tuberculosis, its Nature, Cause, and Treatment.” P. 81. Second edition. Churchill). * See an Articlo on “ Food, Ilent, and Motion” in Dr. Dobell’s Reports on tho Pro- gress of Practical and Scientific Medicine in dilferent parts of tho world. \ ol. I. 1869- Lonomans.$