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14 SOUTHERN MEDICINE & SURGERY February, 1950 plication observed was an occasional post-partuni headache. Thompson believes that in the majority of cases spinal anesthesia offers a simple method of obstetrical anesthesia. He says the doctor will appreciate it, the mother will appreciate it, and the baby would appreciate it if the baby could know of its advantages. Thyroid in Menstrual Disorders (O. Barnes, in Arisona Med., 6:33, 1949) In the majority of patients wit hmenstrual irregularities, no evidence of pathology can be found. This group the genera] practitioner can manage quite successfully. Low B M R and low axillary temp, will be found in practically all these cases. Desiccated thyroid was administered to 143 such patients. usually 1 grain daily for one or two months. If the basal t. was unusually low, initial dose of thyroid was 2 g;rains. If symptoms persisted and basal t. remained low, daily dosage was increased one grain for the following month. Maximal dosage was 4 grains daily. One patient developed symptoms of hyperthyroidism, which subsided upon reducing the dose. Of 48 patients with dysmenorrhea, only 5 failed to experience relief; 35 were completely relieved. Three of the 5 treatment failures had organic disease. Excessive bleeding was treated with desiccated thyroid in 50 cases. Two failed to improve; 2 others improved.; and 46 resumed periods with normal flow. Irregular menstrual cycles were the chief complaints of 45 patients. Two failed to respond to thyroid therapy; 2 improved; and 41 were cured. Voluntary discontinuation of medication by many patients was followed by return of complaints, and desiccated thyroid again brought relief. Fatigue, large sleep requirement, nervousness, irritability, poor appetite, and underweight were corrected in many cases. .Although therapy can be stopped after a few months without a return of menstrual symptoms, many patients will return because they do not feel as well as they did during treatment. There would seem to be no objection to continuation of thyroid therapy as long as the basal t. is not elevated above normal. GENERAL PRACTICE James L. Hamner, M.D., Editor, Mannboro, Va. CRITIQUE OF REPORTS OF SURGICAL AND DIETARY THERAPY IN HYPERTENSION It seems clear that the complications and mortality of hypertensive vascular disease have not as yet been strikingly decreased, despite the glowing reports of the successful dietary, surgical and other treatments of hypertension. INIany years ago, Ayman^ reemphasized the well knouTi but still neglected fact that the variations of blood pressure levels in essential hypertension is one of the clinical characteristics of the disease. The rise of b. p. is usually due to emotional reactions, either pleasant or unpleasant; and the 1. David Ayman, Boston, in Jl. A. M. A., Dec. 3rd. drop to relaxation and calmness. The variations may amount to 100 mm. systolic and 40 mm. diastolic in the course of minutes. A constant higher level of b. p. may last for days or weeks. A period of treatment is a period of reassurance, calmness and a lowering of b. p. IMany patients have been seen whose b. p. at the first visit was 260/ 120 and at a second visit, a few weeks later, 118/80 after only mild sedation and great reassurance. Placebos given to hypertensive patients have produced 80 per cent of symptomatic improvement. During the summer months b. p. is often lower, in the hospital, clinic or office usually higher, than in the home as determined by a member of the household. The original papers on the rice diet in 1944 were titled "Treatment of Kidney Disease and Hypertensive \'ascular Disease with the Rice Diet.*' In this and subsequent papers it is evident that this treatment was carried out principally on patients with acute or chronic nephritis and/or congestive heart failure. In such cases it has always been common to find improvement in heart size and b. p. on the rice diet, a low-sodium, low-protein diet, or receiving digitalis with diuretics. It is clearly necessary to discard all such cases in talking about the effects of the rice diet in pure hypertensive vascular disease. In studies of the effect of the diet on b. p., in "hypertensive vascular disease without conclusive evidence of 'secondary' renal involvement," results in 28 cases are listed as unimproved and in 37 cases as improved. Of the 37 improved patients, 20 were on the diet a month or less when the paper was written. The results of the diet on b. p. are therefore not acceptable because they lack careful, scientific control. Whatever drops in b. p. were noted are easily explained on ahe basis of frequent determinations, reassurance, enthusiasm and relaxation. In all diets, the effect of striking weight reduction as a cause of decrease in b. p. could be ruled out only by maintaining the patient's weight. All agree there is much weight reduction with the rice diet, some with the low-sodium diet. Any drastic dietary restriction will lower b. p. In studies on sympathectomy it is evident again that the glaring defect is the usual brief control period of observation before operation. It is not concluded that dietary or surgical therapy is useless in hypertension. There has been an occasional, definite, moderate improvement in patients on the rice diet and low-sodium intake; in more cases response is made to sympathectomy. The purpose of Ayman's paper is to point out reasons why he does not obtain the results claimed by the authors of such studies when he carries out their therapeutic measures in a controlled manner. It may explain to others their own apparently sue-
Object Description
Rating | |
Fixed Title * | NCHH-22: Southern Medicine and Surgery [1921-1953] |
Document Title | Southern Medicine and Surgery [1921-1953] |
Subject Topical Other | Medicine -- North Carolina -- Periodicals. |
Publisher | Charlotte, N.C. : Charlotte Medical Press, 1921-1953. |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1950 |
Identifier | NCHH-22-112 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 112 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-22/nchh-22-112.pdf |
Document Sort | all; group-e; nchh-22 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-22-112 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-22 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb2542543 |
Revision History | keep |
Description
Fixed Title * | Page 14 |
Document Title | Southern Medicine and Surgery [1921-1953] |
Subject Topical Other | Medicine -- North Carolina -- Periodicals. |
Publisher | Charlotte, N.C. : Charlotte Medical Press, 1921-1953. |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1950 |
Identifier | NCHH-22-112-0020 |
Form General | Periodicals |
Page Type | all; report/review |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | southernmed1121950char_0020.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 112 |
Issue Number | 1 |
Page Number | 14 |
Health Discipline | Medicine |
Full Text | 14 SOUTHERN MEDICINE & SURGERY February, 1950 plication observed was an occasional post-partuni headache. Thompson believes that in the majority of cases spinal anesthesia offers a simple method of obstetrical anesthesia. He says the doctor will appreciate it, the mother will appreciate it, and the baby would appreciate it if the baby could know of its advantages. Thyroid in Menstrual Disorders (O. Barnes, in Arisona Med., 6:33, 1949) In the majority of patients wit hmenstrual irregularities, no evidence of pathology can be found. This group the genera] practitioner can manage quite successfully. Low B M R and low axillary temp, will be found in practically all these cases. Desiccated thyroid was administered to 143 such patients. usually 1 grain daily for one or two months. If the basal t. was unusually low, initial dose of thyroid was 2 g;rains. If symptoms persisted and basal t. remained low, daily dosage was increased one grain for the following month. Maximal dosage was 4 grains daily. One patient developed symptoms of hyperthyroidism, which subsided upon reducing the dose. Of 48 patients with dysmenorrhea, only 5 failed to experience relief; 35 were completely relieved. Three of the 5 treatment failures had organic disease. Excessive bleeding was treated with desiccated thyroid in 50 cases. Two failed to improve; 2 others improved.; and 46 resumed periods with normal flow. Irregular menstrual cycles were the chief complaints of 45 patients. Two failed to respond to thyroid therapy; 2 improved; and 41 were cured. Voluntary discontinuation of medication by many patients was followed by return of complaints, and desiccated thyroid again brought relief. Fatigue, large sleep requirement, nervousness, irritability, poor appetite, and underweight were corrected in many cases. .Although therapy can be stopped after a few months without a return of menstrual symptoms, many patients will return because they do not feel as well as they did during treatment. There would seem to be no objection to continuation of thyroid therapy as long as the basal t. is not elevated above normal. GENERAL PRACTICE James L. Hamner, M.D., Editor, Mannboro, Va. CRITIQUE OF REPORTS OF SURGICAL AND DIETARY THERAPY IN HYPERTENSION It seems clear that the complications and mortality of hypertensive vascular disease have not as yet been strikingly decreased, despite the glowing reports of the successful dietary, surgical and other treatments of hypertension. INIany years ago, Ayman^ reemphasized the well knouTi but still neglected fact that the variations of blood pressure levels in essential hypertension is one of the clinical characteristics of the disease. The rise of b. p. is usually due to emotional reactions, either pleasant or unpleasant; and the 1. David Ayman, Boston, in Jl. A. M. A., Dec. 3rd. drop to relaxation and calmness. The variations may amount to 100 mm. systolic and 40 mm. diastolic in the course of minutes. A constant higher level of b. p. may last for days or weeks. A period of treatment is a period of reassurance, calmness and a lowering of b. p. IMany patients have been seen whose b. p. at the first visit was 260/ 120 and at a second visit, a few weeks later, 118/80 after only mild sedation and great reassurance. Placebos given to hypertensive patients have produced 80 per cent of symptomatic improvement. During the summer months b. p. is often lower, in the hospital, clinic or office usually higher, than in the home as determined by a member of the household. The original papers on the rice diet in 1944 were titled "Treatment of Kidney Disease and Hypertensive \'ascular Disease with the Rice Diet.*' In this and subsequent papers it is evident that this treatment was carried out principally on patients with acute or chronic nephritis and/or congestive heart failure. In such cases it has always been common to find improvement in heart size and b. p. on the rice diet, a low-sodium, low-protein diet, or receiving digitalis with diuretics. It is clearly necessary to discard all such cases in talking about the effects of the rice diet in pure hypertensive vascular disease. In studies of the effect of the diet on b. p., in "hypertensive vascular disease without conclusive evidence of 'secondary' renal involvement" results in 28 cases are listed as unimproved and in 37 cases as improved. Of the 37 improved patients, 20 were on the diet a month or less when the paper was written. The results of the diet on b. p. are therefore not acceptable because they lack careful, scientific control. Whatever drops in b. p. were noted are easily explained on ahe basis of frequent determinations, reassurance, enthusiasm and relaxation. In all diets, the effect of striking weight reduction as a cause of decrease in b. p. could be ruled out only by maintaining the patient's weight. All agree there is much weight reduction with the rice diet, some with the low-sodium diet. Any drastic dietary restriction will lower b. p. In studies on sympathectomy it is evident again that the glaring defect is the usual brief control period of observation before operation. It is not concluded that dietary or surgical therapy is useless in hypertension. There has been an occasional, definite, moderate improvement in patients on the rice diet and low-sodium intake; in more cases response is made to sympathectomy. The purpose of Ayman's paper is to point out reasons why he does not obtain the results claimed by the authors of such studies when he carries out their therapeutic measures in a controlled manner. It may explain to others their own apparently sue- |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-22/nchh-22-112.pdf |
Document Sort | all; group-e; nchh-22 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-22-112 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-22 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb2542543 |
Revision History | keep |
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