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    The Starvation Treatment of Diabetes
    The Starvation Treatment of Diabetes
    The Starvation Treatment of Diabetes
    Ebook166 pages1 hour

    The Starvation Treatment of Diabetes

    By Rena Sarah Eckman and Lewis Webb Hill

    ()

    Read preview
    LanguageEnglish
    PublisherArchive Classics
    Release dateNov 26, 2013
    The Starvation Treatment of Diabetes

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      Book preview

      The Starvation Treatment of Diabetes - Rena Sarah Eckman

      The Project Gutenberg EBook of The Starvation Treatment of Diabetes, by

      Lewis Webb Hill and Rena S. Eckman

      This eBook is for the use of anyone anywhere at no cost and with

      almost no restrictions whatsoever. You may copy it, give it away or

      re-use it under the terms of the Project Gutenberg License included

      with this eBook or online at www.gutenberg.net

      Title: The Starvation Treatment of Diabetes

      Author: Lewis Webb Hill

      Rena S. Eckman

      Release Date: July 14, 2008 [EBook #26058]

      Language: English

      *** START OF THIS PROJECT GUTENBERG EBOOK STARVATION TREATMENT OF DIABETES ***

      Produced by Stacy Brown, Bryan Ness and the Online

      Distributed Proofreading Team at http://www.pgdp.net (This

      book was produced from scanned images of public domain

      material from the Google Print project.)

      THE

      STARVATION TREATMENT

      OF DIABETES

      With a Series of Graduated Diets

      used at the

      MASSACHUSETTS GENERAL HOSPITAL

      by

      LEWIS WEBB HILL, M.D.

      Children's Hospital, Boston

      and

      RENA S. ECKMAN

      Dietitian, Massachusetts General Hospital, Boston

      With an Introduction by

      RICHARD C. CABOT, M.D.

      Second Edition

      Boston, Mass.

      W. M. LEONARD

      1916

      Copyrighted 1915

      by

      W. M. Leonard

      Second Edition First Edition Printed August, 1915

      Second Edition Printed January, 1916

      Second Edition Reprinted April, 1916

      INTRODUCTION.

      Although Dr. Allen's modifications of the classical treatment of saccharine diabetes have been in use only for about two years in the hands of their author, and for a much shorter time in those of other physicians, it seems to me already clearly proven that Dr. Allen has notably advanced our ability to combat the disease.

      One of the difficulties which is likely to prevent the wide adoption of his treatment is the detailed knowledge of food composition and calorie value which it requires. Dr. Hill's and Miss Eckman's little book should afford substantial aid to all who have not had opportunity of working out in detail the progressive series of diets which should be used after the starvation period. These diets, worked out by Miss Eckman, head of the diet kitchen at the Massachusetts General Hospital, have seemed to me to work admirably with the patients who have taken them, both in hospital and private practice. The use of thrice boiled vegetables, as recommended by Dr. Allen, seems to be a substantial step in advance, giving, as it does, a considerable bulk of food without any considerable carbohydrate portion, and with the semblance of some of the forbidden vegetables.

      It is, of course, too early to say how far reaching and how permanent the effects of such a diet will be in the severe and in the milder cases of diabetes. All we can say is that thus far it appears to work admirably well. To all who wish to give their patients the benefit of this treatment I can heartily recommend this book.

      Richard C. Cabot.

      PREFACE TO FIRST EDITION.

      The purpose of this little book is to furnish to the general practitioner in compact form the details of the latest and most successful treatment of diabetes mellitus.

      The starvation treatment of diabetes, as advanced by Dr. Frederick M. Allen of the Rockefeller Institute Hospital, is undoubtedly a most valuable treatment. At the Massachusetts General Hospital it has been used for several months with great success, and it is thought worth while to publish some of the diets, and details of treatment that have been used there, as a very careful control of the proteid and carbohydrate intake is of the utmost importance if the treatment is to be successful. In carrying out the Allen treatment the physician must think in grams of carbohydrate and proteid—it is not enough simply to cut down the supply of starchy foods; he must know approximately how much carbohydrate and proteid his patient is getting each day. It is not easy for a busy practitioner to figure out these dietary values, and for this reason the calculated series of diets given here may be of service. The various tests for sugar, acetone, etc., can, of course, be found in any good text-book of chemistry, but it is thought worth while to include them here for the sake of completeness and ready reference. The food table covers most of the ordinary foods.

      We wish to thank Dr. Roger I. Lee and Dr. William H. Smith, visiting physicians, for many helpful suggestions.

      PREFACE TO SECOND EDITION.

      The Authors beg to thank the Profession for the cordial reception given the first edition of this book. The present edition has been revised and enlarged, with the addition of considerable new material which we hope will be of use.

      January, 1916.

      DETAILS OF TREATMENT.

      For forty-eight hours after admission to the hospital the patient is kept on ordinary diet, to determine the severity of his diabetes. Then he is starved, and no food allowed save whiskey and black coffee. The whiskey is given in the coffee: 1 ounce of whiskey every two hours, from 7 a.m. until 7 p.m. This furnishes roughly about 800 calories. The whiskey is not an essential part of the treatment; it merely furnishes a few calories and keeps the patient more comfortable while he is being starved. If it is not desired to give whiskey, bouillon or any clear soup may be given instead. The water intake need not be restricted. Soda bicarbonate may be given, two drachms every three hours, if there is much evidence of acidosis, as indicated by strong acetone and diacetic acid reactions in the urine, or a strong acetone odor to the breath. In most cases, however, this is not at all necessary, and there is no danger of producing coma by the starvation. This is indeed the most important point that Dr. Allen has brought out in his treatment. At first it was thought best to keep patients in bed during the fast, but it is undoubtedly true that most patients do better and become sugar-free more quickly if they are up and around, taking a moderate amount of exercise for at least a part of the day. Starvation is continued until the urine shows no sugar. (The daily weight and daily urine examinations are, of course, recorded.) The disappearance of the sugar is rapid: if there has been 5 or 6 per cent., after the first starvation day it goes down to perhaps 2 per cent., and the next day the patient may be entirely sugar-free or perhaps have .2 or .3 per cent. of sugar. Occasionally it may take longer; the longest we have starved any patient is four days, but we know of obstinate cases that have been starved for as long as ten or eleven days without bad results. The patients tolerate starvation remarkably well; in no cases have we seen

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