Frederick M. (Frederick Madison) Allen.

Total dietary regulation in the treatment of diabetes online

. (page 68 of 76)
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22.5

ii


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a it it


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66


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1770
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246


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845


200


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246


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744


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1031


200


66




50








26














Dh


:iitiz


@d bv Mic


rose


:ft®






























;







* The four columns represent the four periods into which each day's urine is divided.



TABLE III.



Urine.


Blood.




trose.*






FeCls


Nitroprusside.


i




Acetone bodies as acetone.




3

<


Remarks.


Plasma.


1


Total fatty acid.


Cholesterol.


Lecithin.




3


4


Gm.


t-i

1^


&

o


4.11

3.52


i


lis


+1

sis

<


■32.


u ft


6

i

s

1


4,

1

ft
►3


o

1


'6
J

1


J

CM


a
o
U


■g

o
'o




;3

&

o


o

o




&

o
U


Remarks and clinical notes.


H.
"aint.


Mod.

Neg.


12.87


gm.
5.03
6.02


H.

Mod.


V.H.
H.


gm.
1.05

0.71


gm.


gm.

1.05

2.48


gm.
3.12
1.04


cc.

205
215


Neg.


10:30 a.m.
11:30 "


per cent

0.227
0.106


vol.
per cent

64.3
58.6


mg.
12

12.5


mg.

26.0
43.7


mg.

38.0
56.2


++
++


+

Neg.


per cent

85
103


per cent
44.6
46,2


per cent

1.63
0.95


per cent

1.75
1.02


Per cent
1.32
0.93


per cent
0.60
0.55


per cent

0.65
0.59


per cent

0.42
0.51


per cent

0.25
0.21


per cent

0.19
0.14


per cent
0.31
0.26


Patient admitted.


Neg.

iC -

a


ii

ii
li







S.S7
4.77
5.61




SI.

Faint.
ii


li

Mod.+
H.


0.63
0.20
0.27




1.49
1.71
1.19


1.96
1.34
0.75


3.45
3.05
1.94


199
200
195


ii
CI
ii








































Carbohydrate test begun.


li


li

a






4.09
3.25




a
a


li
ii


0.24
0.21




0.30
0.42


0.35
1.08


0.85
1.50


130
117


li

ii










































iC


ii





4.66




a


Mod.+


0.14




0.44


0.51


0.95


65


ii










































faint.


li





5.14




ii


Mod.


0.11




0.31


0.63


0.94


35


ii










































Neg.


V. faint.





6.30




a


11


0.13




0.13


0.29


0.42


75


it










































"aint.

Neg.

ii
ii
ii


Neg.

a









5.41
5.48

9.41
9.62
7.14




Neg.
Faint.

Neg.

a

Faint.


li
(I

li

S1.+

ii


it

0.21

0.63
0.56
0.39




0.18
0.27


0.27
0.37


0.45
0.64


51
160

220
231
216


it

ii

li
it


9:30 a.m.


0.133


63.2


Tr.


36.2


36.2








99


45.3


0.57


0.63


0.52


0.42


0.45


0.39


0.19


0.13


0.23


End of carbohydrate test.
Beginning of low calory diet to clear up
hyperglycemia and ketonuria.


it


ii





9.77




it


it


0.16













211


it










































a


a










Neg.


V. Faint.



















"










































"


li

ii











it


SI.
S1.+



















li


5:00 p.m.
12:00 n.


0.123

li


64.4
71.0


Neg.

11


13.2
11.3


13.2
11.3










98

li


47.7
51.0


0.55
0.57


0.61
0.60


0.50
0.55


0.38
0.40


0.41
0.43


0.37
0.39


0.23
0.21


0.17
0.16


0.29
0.24


Weekly fast-day.


ii


a










U


Faint.






















10:00 a.m.


0.083


69.1


li


7.0


7.0








96


52.0


0.61


0.65


0.59


0.32


0.36


0.30


It


0.19


0.23




a


ii










it


11






























































it


a










u


Neg.






























































a


a










n


it





















9:30 a.m.


0.076


68.1

















101


44.5


0.51


0.56


0.49


0.26


0.30


0.21


0.30


0.28


0.38




ii


a










a


it















-





10:15 "


0.123


62.4

















98


37.2


0.53


0.54


0.51


0.28


it


0.26


0.29


0.24


0.32




i(
it


ii ■

a













tt

li















— "





10:00 "


0.104


62.3
















96


39.8


0.49


ii


0.45


0.31


0.36


0.29


0.21


0.18


0.27


Weekly fast-day.


it


a











((


it


-







-


-


-


-


5:15 p.m.


0.114

Dig


67.2

'tize


dlb)


' Mk


:ros








98


46.0


0.52


0.56


0.49


0.25


0.27


0.21


0.32


0.27


0.38





CUHBOHTDRATE



Cjojokos



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110.7

106.6

102.5

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34.3

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66.1

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40 SO 60 70 SO 90

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10 »0 SO 40 50 60 70 ao 90 100

Digitized 5f^mh%W^

Chart 1.



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40 so 60 70 80 »0

rOODSTUFTi IN6M.





i %



"Hi



General data.


Family history.


Past history.




Sex.


Nationality or
race.


Age.


Occupation.


Diabetes..


Obesity.


Tuberculosis.


Other disorders.


Infections and accidents-


Nervous system.


Activity.


Habits.


Figure.


Digestion.




.a
e


Childhood.


Adult.


Wasser-
mann test


Alcohol.


Tobacco.


Appetite and
diet.


Boi


1


F.


American.


yrs.
28


None.






Uncle (1).


Father, tendency
to melancholia.
Sister, nephritis.


Measles, diarrhea.






Naturally nervous ;
unhappy love
affair.


Overs treiiuous
socially.






Fond of eat-
ing; excess
in sweets.


Thin.


Good.


Moder
stipa


2


Italian.


17


Sewing ma-
chine oper-
ator.




Father; broth-
er (moder-
ate).






u






Phlegmatic.


Swpat-shop.

i


Slight.




Moderate.


Slightly
obese.




Regula


J


M.
F.


American.


26


None.






Maternal
grandfather;
father; un-
cle.


Maternal aunt
died of melan-
cholia. Brother
nervous.


" mumps; chick-
en-pox; typhoid; ton-
sillitis.


"Colitis;" grippe; inter-
costal rheumatism; ap-
pendicitis; appendec-
tomy; oophorectomy;
phlebitis.




Sensitive.


Some social
strain.

1







Much candy.


Normal.


u


i


4




12




Sister; pater-
nal grand-
father; un-
cle.






Maternal grand-
mother, cancer.
Neurotic on
father's side.


Abscess on neck; bron-
chitis; rheumatism;
measles; chicken-pox;
tonsillitis.






Precocious; neu-
rotic.


Normal.


-




Sweets re-
stricted.


Plump.




a


6




34


Customs in-
spector.








-


Measles; tonsillitis.


Gonorrhea; acute pan-
creatitis (?).




Neurotic.


\
i


Occasional ex-
cess.


Moderate.


Irregular.


Normal.


Poor.


Consti





Italian.


48


Housewife.


(Husband now


diabetic. Patie


nt very ignoran


t.)


Unknown.






Phlegmatic.


Tenement life.


Slight.




No excess.


Slightly
obese.


Good.


Regula


/




American
(Swedish) .


36


Saleswoman.










Scarlet fever.


Miscarriage.




Nervousness per-
haps due only
to diabetes.


Unhappy mar-
ried life.


Excess (?).




Light eater;
coffee to
excess.


Obese.


i(


a


8


M.

a

i(

F.
M.


American.


29


Printer.








Mother, simple
goiter.


Measles; chicken-pox;
mumps.


Slight pleurisy.





Normal.


Normal.


Little.


Little.


No excess.


Thin.


a


Slightl)
stipa


y


Jew.


24


Tailor.








-•#


(Memory uncertain.)
Rheumatism.


Gonorrhea; bronchitis;
frequent colds.




Neurotic.


! il

1
i




Moderate.


Ordinary.


Normal.




Constif


10


American
(Irish).


17


Plumber.










Measles; whooping-
cough.






Normal.


Healthful.

i






Large; much
sweets.


u


((


Regula


11


Austrian.


55


Housewife.




Obese family.






Measles.


4 miscarriages.




i(


Ordinary.


Slight.




Excess de- .
nied.


Very obese.


a


a


12


Jew.


49


Tailor.




Moderate.








Partial tonsillectomy.




ti


I

1


a


Moderate.


No excess.


Obese.


iC


il
1



Digitized by Microsoft©



TABLE 1— General Summary.



Past history.


Diabetic history.




Activity.


Habits.


Figure.


Digestion.


Bowels.


Onset.


Glycosuria discovered.


Weight.


Polypha-
gia.


Polydipsia

and

polyuria.


Pruritus.


Skin infections.


Albuminuria.


Menstruation or
sexual function.


Pains.


Alopecia.


Ac


system.


Alcohol.


Tobacco.


Appetite and
diet.


Acute or
gradual.


Date o-f first
symptoms.


Time.


Cause of examina-
tion.


Highest.


At
onset.


At
admis-
sion.


Degree.




^nervous;
)y love


Overstrenuous
socially.






Fond of eat-
ing ; excess
in sweets.


Thin.


Good.


Moderate con-
stipation.


x\cute.


Jan., 1913


July 6, 1913


Polydipsia ; poly-
phagia; pru-
ritus.


kg.
56.8


kg.


kg.

40.1
42.6


+


. +


Marked.




-


Stopped May,
1913.




Marked.


Heavy.


+


ic.


Sweat-shop.


Slight.




Moderate.


Slightly
obese.


il


Regular.


Gradual.


Dec, 1912


Mar. 14,
1913


Weakness; loss
of weight;
polyphagia;
polydipsia.


5.45


40.9


+


+








Stopped Feb.,
1913.


Headaches.




Moderate.






Some social
strain.






Much candy.


Normal.


ii




-■^cute.


Jan., 1913


May, 1913


Weakness; loss
of weight.


54.5


49.5


46.5


+


+








Normal.




Marked.


a




is; neu-


Normal.






Sweets re-
stricted.


Plump.




a


ii


Summer,
1907


Immediate.


Polyphagia;
polyuria.


31.8




23.8


+


+




Two ulcers.


Slight 1st 15
days; slight
terminal.




Neuritic in
legs.


Slight.


Heavy at
times.


+






Occasional ex-
cess.


Moderate.


Irregular.


Normal.


Poor.


Constipated.


a


July, 1913


Sept., 1913


Polydipsia; loss
of weight and
strength.


79.5


72.3


60.4


+


+






Faint 1st 11
days.


Lessened libido.


Back and legs.


Present, but
not con-
nected with
diabetes.


Slight.




ic.


Tenement life.


Slight.




No excess.


Slightly
obese.


Good.


Regular.


Unknown.




July 25,
1914


Hospital rou-
tine.






58.8










Faint 1st 15
days.


Climacteric 1913.






i(




ess per-
ue only
etes.


Unhappy mar-
ried life.


Excess (?).




Light eater;
coffee to
excess.


Obese.


u




Acute.


Dec, 1913


Mar., 1914


Pruritus; loss of
weight.


76.3




52.8
50




+


Vulvar,
marked.


Superficial vul-
var; also

styes.


Faint, transi-
tory.


Normal.


Severe in legs.


Marked.


ii






Normal.


Little.


Little.


No excess.


Thin.


ii


Slightly con-
stipated.
Constipated.


ii


June, 1913


June, 1913


Polydipsia.


68.2




+


+









Absent.




Slight.


Heavy.


+




a


a


Moderate.


Ordinary.


Normal.


ii


ii


Oct., 1913


Oct., 1913


Bronchitis.




68.2


53.6


+


+










Headaches.




it






Healthful.






Large; much
sweets.


a


ii


Regular.


ii


Jan., 1914


June, 1914


Polydipsia; loss
of weight.


60.5




41.6


+


+




Cervical swell-
ing of un-
known na-
ture.


Moderate 1st 3
days.








ii


+




Ordinary.


Slight.




Excess de-
nied.


Very obese.


ii


a


Gradual.


1904


1907


Bitter taste;
constipation.


91.3




74.2










Heavy.


Stopped.


Head, thorax,
and abdo-
men.


Beginning.


a


+




it


ii


Moderate.


No excess.


Obese.


il


ii


Acute.


1911


Immediate. Weakness; poly- 91
dipsia.

DiQitized by Microsoft®


86


Transi-
tory.


Transi-
tory.


Slight.


Lichen planus
of arms; ul-
cers of feet.


Faint


Normal .


Neuritic in
back and
legs.


Present, not
due to dia-
betes.


Slight.



























Physical examination.




















Menstruation or
sexual function.


Pains .


Alopecia.


Acidosis.


Complexion.


Nutrition.


Thyroid.


Teeth.


Tonsils.


Heart.


Lungs.


Liver.


Lymph glands.


Knee jerks.


Blood
pressure.




ria.


Degree.


it

a "
+


Hyperp-
nea.


Digestive
symptoms.


it


2 o


Remarks.




Stopped May,
1913.




Marked.


Heavy.


+


-


Pale.


Emaciated.


Normal.


Good.


Normal.


Normal.


Normal.


Normal.


Normal.


Normal.


103


80


Lower pole of right kidney pal-
pable; incipient coma.




Stopped Feb.,
1913.


Headaches.




Moderate.








Good.


Medium.


a


ti


Slightly hyper-
trophied.


it


a


ti


it


ti






Strong peasant type.




Normal.




Marked.


it


+






a


Good.


It


it


Normal.


a




ti


it




120




Temporary weakness of vision.


t IS
slight

.




Neuritic in
legs.


Slight.


Heavy at
times.


+


Vomiting.


Sallow.


Emaciated.


it


Poorly devel-
oped.


Slightly hyper-
trophied.


ti


ti


it


Slight cervical en-
largeiaent.


Diminished.


ISO

. lis


lis

70


Chronic nephritis; nearly total
blindness from retinitis.


t 11


Lessened libido.


Back and legs.


Present, but
not con-
nected with
diabetes.


Slight.








a


Fair.


it


Poorly devel-
oped.


Hypertrophied;
no pus foci.




ti


Normal at first;
subsequent hy-
pertrophy and
atrophy.


Slight general
adenopathy.


Normal.


Cirrhosis of liver.


t 15


Climacteric 1913.






a


-






Cyanotic.


Good.




Caries; pyor-
rhea.


Hypertrophied;
congested;
no pus foci.


Hypertrophied.


Lobar pneu-
monia.


Edge felt at costal
margin.


Normal.


Sluggish.


Admitted for pneumonia.


ransi-


Normal.


Severe in legs.


Marked.


a






Fair.


Fair.


ti


Fair; consider-
abte tartar.


Normal.


Normal.


Normal.


Normal.


Slight posterior
cervical enlarge-
ment.


Normal.




60

75

95



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