- Email: [email protected]
HIGH PROTEIN DIETS IN ALBUMINURIA OF PREGNANCY
99 liver gave a value of 127,000 guinea-pig units, while that of a case of pernicious ansemia in partial remission had a value of 47,000, and that of two cases in relapse had a value of only 650 and 380 guinea-pig units. The material in liver, therefore, which is reticulocytogenic in the guinea-pig is at least closely related to the material effective in pernicious an2emia. The administration of the extrinsic factor of Castle alone to guinea-pigs was ineffective, but extrinsic factor predigested with gastric juice was reticulocytogenic. Comparative studies of potency of certain materials carried out on guinea-pigs and patients gave results which agreed in a satisfactory manner. The rise in reticulocytes considered positive by Jacobson is slight, but from considerable experience he claims that provided a rigorous technique is employed the results obtained are significant and he concludes that regardless of the obscurity of the basis of -the phenomenon the guinea-pig test is a valid indicator of the therapeutic efficiency of materials effective in pernicious anaemia.
while looking back upon an honourable past useful future is open to it. Dr. MacDermot supplies an interesting chapter in medical history.
to-day, a
HIGH PROTEIN DIETS IN ALBUMINURIA OF PREGNANCY
devising of diets for the toxsemias of is no end, nor is there likely to be there pregnancy as long as the aetiology of these disorders remains obscure. But while most of the regimes which have been proposed have enjoyed only transient or local vogue, there is a fairly widespread and persistent impression that protein is bad for the potential eclamptic. How this impression has gained credence is not clear, for the idea of eclampsia as a result of rotting of flesh food in an obstructed bowel To the
seems
to
depend
more
on
vegetarian superstition
than on scientific fact. Nevertheless, the superstition dies hard and there is little doubt that protein restriction is widely practised, not only in toxsemia but also in normal pregnancy. There is no convincing evidence that the practice does good, but is it certain THE CANADIAN MEDICAL ASSOCIATION 1 that protein restriction is not harmful in pregnancy ? THAT the history of medicine is, speaking in general After all the full-term uterus and its contents represent a considerable mass of protein which must come terms, a history of civilisation, is becoming more either from the mother’s diet or from the protein obvious as more historical reading is placed before us. reserves of her own muscles. A recent paper by For numerous books which havebeen published B. 1 has some bearing on these reflections, M. Strauss during the last 20 years tell the story of medical for he that the protein content of the diet improvements and developments as they are con- and alsoreports the concentration of protein in the blood temporary with the evolution of general politics. is than normal in cases of lower consistently The fact that throughout the most troublous times plasma he found that toxsemia. Moreover, in the story of nations medicine has gone steadily pre-eclamptic he treated such with when diets poor in patients on its way, while dominions and powers disappear the oedema and albuminuria were aggravated ; protein or are modified out of their original schemes, contrasts the record of medicine as a continuous one with general whereas a high protein diet led to a reduction of the oedema and improvement of the toxsemic symptoms. history which has been subjected to countless breaks The significance of these observations is not, as yet, and setbacks. One great example only of this steady for the improvement in the latter group may clear, progress will suffice-it stares us in the face. The have been partly due to simultaneous administration recent European war has seen a complete dissolution of vitamin B. The number of cases so far treated of many political systems, while the science of medicine small and it is well known that simple has also been has not only maintained its progress but has benefited in often cause considerable improvement. rest bed will in obvious directions by the opportunities given for It would certainly be unwise to infer that protein new work to meet new circumstances. Dr. is an important cause of toxsemia, for it starvation MacDermot in telling the story of the Canadian be remembered must that the incidence of eclampsia Medical Association shows very well that when was abnormally low in the starving central European idea of has been once the perceived, cooperative action the medical spirit will lead to organised action, and countries during the last war. The problem goes that the results of that action will be for the public deeper than that ; but Strauss’s paper should at prompt the obstetrician to ask himself whether good, whatever troubles general society as a whole least he is justified in depriving the pregnant woman of may be going through. The Canadian Medical protein. Association grew from small beginnings and for many years its position was quite precarious. SYMPATHECTOMY FOR DYSMENORRHŒA Attempts to organise medicine in Canada were THE cause of primary dysmenorrhoea has never made at least 90 years ago, but for the first 50 years been ascertained. On the assumption that it may they were abortive, or only useful in affording arise from some disturbance or imbalance of the experience to others who were resolved to carry on the work. At the end of the last century, however, sympathetic innervation of the uterus, interruption and indeed up to the breaking out of the European of the sympathetic supply has of recent years been advocated and practised with considerable success. war, the Association became representative of the Canadian profession, established a relationship with Of the several methods which have been devised local and provincial medical societies, and issued that of Cotte (resection of the superior hypogastric a journal which promised to be well established. plexus) seems to be the most satisfactory. V. S. Then came the war when the systematic work of the Counseller and W. McK. Craig2 have reported Association was sharply curtailed, for its individual 14 cases from the Mayo Clinic, of which it is stated members were mostly involved in military duties and that 9 obtained 100 per cent., 2 obtained 95 per a mere skeleton of the organisation remained. It cent., and 3 obtained 75 per cent. relief ; there were was contrived, however, to keep the journal alive, A discusno deaths and no serious complications. and three years after the war a strong committee sion held by the section of obstetrics and gynaecology restored the Association to a stable position, so that of the Royal Society of Medicine3 two years ago 1 History of the Canadian Medical Association, 1867-1921. By H. E. MacDermot, M.D., F.R.C.S. (C.). Toronto: Murray Printing Co., Ltd. 1935. Pp. 209.
1 Amer. Jour. Med. Sci., December, 1935, p. 811. 2 Amer. Jour. Obst. and Gyn., 1934, xxviii., 161. 3 Proc. Roy. Soc. Med., 1934, xxvii., 258.
while looking back upon an honourable past useful future is open to it. Dr. MacDermot supplies an interesting chapter in medical history.
to-day, a
HIGH PROTEIN DIETS IN ALBUMINURIA OF PREGNANCY
devising of diets for the toxsemias of is no end, nor is there likely to be there pregnancy as long as the aetiology of these disorders remains obscure. But while most of the regimes which have been proposed have enjoyed only transient or local vogue, there is a fairly widespread and persistent impression that protein is bad for the potential eclamptic. How this impression has gained credence is not clear, for the idea of eclampsia as a result of rotting of flesh food in an obstructed bowel To the
seems
to
depend
more
on
vegetarian superstition
than on scientific fact. Nevertheless, the superstition dies hard and there is little doubt that protein restriction is widely practised, not only in toxsemia but also in normal pregnancy. There is no convincing evidence that the practice does good, but is it certain THE CANADIAN MEDICAL ASSOCIATION 1 that protein restriction is not harmful in pregnancy ? THAT the history of medicine is, speaking in general After all the full-term uterus and its contents represent a considerable mass of protein which must come terms, a history of civilisation, is becoming more either from the mother’s diet or from the protein obvious as more historical reading is placed before us. reserves of her own muscles. A recent paper by For numerous books which havebeen published B. 1 has some bearing on these reflections, M. Strauss during the last 20 years tell the story of medical for he that the protein content of the diet improvements and developments as they are con- and alsoreports the concentration of protein in the blood temporary with the evolution of general politics. is than normal in cases of lower consistently The fact that throughout the most troublous times plasma he found that toxsemia. Moreover, in the story of nations medicine has gone steadily pre-eclamptic he treated such with when diets poor in patients on its way, while dominions and powers disappear the oedema and albuminuria were aggravated ; protein or are modified out of their original schemes, contrasts the record of medicine as a continuous one with general whereas a high protein diet led to a reduction of the oedema and improvement of the toxsemic symptoms. history which has been subjected to countless breaks The significance of these observations is not, as yet, and setbacks. One great example only of this steady for the improvement in the latter group may clear, progress will suffice-it stares us in the face. The have been partly due to simultaneous administration recent European war has seen a complete dissolution of vitamin B. The number of cases so far treated of many political systems, while the science of medicine small and it is well known that simple has also been has not only maintained its progress but has benefited in often cause considerable improvement. rest bed will in obvious directions by the opportunities given for It would certainly be unwise to infer that protein new work to meet new circumstances. Dr. is an important cause of toxsemia, for it starvation MacDermot in telling the story of the Canadian be remembered must that the incidence of eclampsia Medical Association shows very well that when was abnormally low in the starving central European idea of has been once the perceived, cooperative action the medical spirit will lead to organised action, and countries during the last war. The problem goes that the results of that action will be for the public deeper than that ; but Strauss’s paper should at prompt the obstetrician to ask himself whether good, whatever troubles general society as a whole least he is justified in depriving the pregnant woman of may be going through. The Canadian Medical protein. Association grew from small beginnings and for many years its position was quite precarious. SYMPATHECTOMY FOR DYSMENORRHŒA Attempts to organise medicine in Canada were THE cause of primary dysmenorrhoea has never made at least 90 years ago, but for the first 50 years been ascertained. On the assumption that it may they were abortive, or only useful in affording arise from some disturbance or imbalance of the experience to others who were resolved to carry on the work. At the end of the last century, however, sympathetic innervation of the uterus, interruption and indeed up to the breaking out of the European of the sympathetic supply has of recent years been advocated and practised with considerable success. war, the Association became representative of the Canadian profession, established a relationship with Of the several methods which have been devised local and provincial medical societies, and issued that of Cotte (resection of the superior hypogastric a journal which promised to be well established. plexus) seems to be the most satisfactory. V. S. Then came the war when the systematic work of the Counseller and W. McK. Craig2 have reported Association was sharply curtailed, for its individual 14 cases from the Mayo Clinic, of which it is stated members were mostly involved in military duties and that 9 obtained 100 per cent., 2 obtained 95 per a mere skeleton of the organisation remained. It cent., and 3 obtained 75 per cent. relief ; there were was contrived, however, to keep the journal alive, A discusno deaths and no serious complications. and three years after the war a strong committee sion held by the section of obstetrics and gynaecology restored the Association to a stable position, so that of the Royal Society of Medicine3 two years ago 1 History of the Canadian Medical Association, 1867-1921. By H. E. MacDermot, M.D., F.R.C.S. (C.). Toronto: Murray Printing Co., Ltd. 1935. Pp. 209.
1 Amer. Jour. Med. Sci., December, 1935, p. 811. 2 Amer. Jour. Obst. and Gyn., 1934, xxviii., 161. 3 Proc. Roy. Soc. Med., 1934, xxvii., 258.