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

  • Dobell, Horace, 1828-1917.
Date:
[1872?]
Catalogue details

Licence: Public Domain Mark

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

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    selected a less questionable term than Tabes Mesenterica, I should have fulfilled my intention of writing the article at that time; but when looking up my cases for the purpose, I found it so difficult to prove in those that had recovered that the mesenteric glands were the seat of disease, that I thought it better to postpone the article till I had a new series of cases in which the diagnostics of that point had been more minutely recorded. In this paper I propose to drop the question of disease of the mesen¬ teric glands, and simply to speak of the class of cases constituting that wretched form of “ atrophy and debility ” and “ marasmus ” in child¬ ren, in which every part of the body wastes away except the abdo¬ men; the state described by Dr. Druitt, in the last edition of his “ Yade Mecum,’’ in the following few and graphic words:—“ Emaciation and voracity; the belly swelled and hard; the skin dry and harsh ; the eyes red; the tongue strawberry-coloured; the breath foul; the stools clay-coloured and offensive, sometimes costive, sometimes extremely relaxed; the patient usually dies hectic” (p. 75). I wish to bring prominently forward the fact that this state, pro¬ vided there is no advanced lung-disease, is rapidly cured by Pancreatic Emulsion given in doses of a teaspoonful every four hours, and regu¬ larly persisted in till fat and flesh are restored. It is, of course, necessary that a proper diet should be insisted on at the same time; but proper diet without the Pancreatic Emulsion will not do. This I have found over and over again in cases where everything judicious in the way of feeding and cod liver oil had been carefully and persever- ingly tried without avail, but which, on the addition of the Emulsion to the previous diet, began at once to improve. This fact has been familiar to me for a long time ; and considering how largely Pancreatic Emulsion is now used in the wasting diseases of adults, I am surprised to find that it is not even referred to in the latest works on the diseases of children. Looking through these works and examining their indexes, one is led to the conclusion that their authors are not aware that there is such an organ as the pan¬ creas, or that pancreatic juice has ever been used in any form in the treatment of disease.* Yet scarcely a week now passes but some gene¬ ral practitioner relates to me cases of the successful use in his own practice of Pancreatic Emulsion in the wasting of delicate children. Dr. Prospero Sonsino’s paper will, I hope, excite more general attention to this important subject. He, however, has laid all the stress of his observations upon the influence of the salivary and pan¬ creatic juices on the digestion of starch. This is unquestionably a point of the greatest importance in the case of very young children brought up by hand, as showing the absurdity of attempting to nourish them upon starchy food, not artificially digested, before the period of life at which the saliva and pancreatic juice attain their functional activity. And even then, as Dr. Sonsino afterwards re- * The word “pancreas” does not occur in the indexes of the last editions of West, Tanner, Vogel, Meigs and Pepper, Eustace Smith, Churchill, on Diseases of Children.