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March, 1945 RICE DIET—KEMPNER 129 9-18-42 223/123 MM.HG. 2-16-43 14/82 MM.HG. Fig. 35. N. McL. Chronic glomerulonephritis. Rice diet started September 28, 1942. No digitalis. Reduction in heart size with change in transverse diameter of 39 per cent. History: The patient had had measles and pellagra in childhood, and "kidney trouble" at 17. She had received blood transfusions for anemia in the following years. At 22, she was treated for oliguria and dysuria; at 25-26, she had edema of the ankles and face. She had malaria and erysipelas of the leg when she was 27. Between 28 and 29, her vision began to fail; her physician told her that this was due to kidney disease. At 30, she had "something like a stroke," which cleared up after two or three weeks of bed rest. The patient had never been pregnant. One year before admission, she was treated with "injections" and blood transfusions for anemia, and with diuretics and other medication for hypertension and "kidney trouble." Her vision was poor; she complained of diplopia and scotomata. There was edema of the feet and legs. She had dyspnea on exertion, paroxysmal nocturnal dyspnea, a feeling of substernal oppression, tachycardia and palpitation. On examination, her height was 156 cm., her weight 82.2 Kg., temperature 37.5 C., pulse 88, respiration 20, blood pressure 190 systolic, 120 diastolic. Slight edema of the ankles and lower legs was noted. Extraocular movements were normal; the pupils were equal and reacted well to light and accommodation. Both discs were blurred on the nasal and temporal sides; the arterioles were silverish and moderately tortuous. A hemorrhage was present in the lower nasal region of the left eye. The teeth were carious, the tonsils enlarged. The lungs showed no pathological findings on percussion and auscultation. The heart was enlarged to the left and right; a soft systolic aortic murmur was heard. The abdomen was obese; no masses were felt, the liver was not enlarged, the spleen was not palpable, and no tenderness was present in either kidney region. The uterus was of normal size with a second degree retroversion. Neurological examination did not show any pathological findings. A chest film (fig. 35) was read: "Lungs clear. Heart enlarged." The transverse diameter of the heart was 16.7 cm. A flat plate of the abdomen and a retrograde pyelogram were reported as follows: "Kidney normal in outline, no stones seen. Calices and pelves on both sides normal. Spleen slightly enlarged." The electrocardiogram (fig. 36) showed a depressed RT segment in lead 1, diphasic Ti, and a normal sinus rhythm. The basal metabolic rate was —11 per cent. Accessory clinical findings: The hemoglobin was 92 per cent, red blood cells 4,-410,000, white blood cells 6,400 with 1 per cent non-segmented polymorphonuclears, 60 per cent segmented polymorphonuclears, 1 per cent basophils, 5 per cent monocytes, 6 per cent large lymphocytes, 27 per cent small lymphocytes; the corrected sedimentation rate was 18 mm. in one hour. Serological
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1945 |
Identifier | NCHH-17-006 |
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 | 6 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-006.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-006 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Description
Fixed Title * | Page 129 (image) |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1945 |
Identifier | NCHH-17-006-0141 |
Form General | Periodicals |
Page Type | all; all images; x-ray; article |
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 | northcarolinamed61945medi_0141.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 | 6 |
Issue Number | 3 |
Page Number | 129 |
Health Discipline | Medicine |
Full Text | March, 1945 RICE DIET—KEMPNER 129 9-18-42 223/123 MM.HG. 2-16-43 14/82 MM.HG. Fig. 35. N. McL. Chronic glomerulonephritis. Rice diet started September 28, 1942. No digitalis. Reduction in heart size with change in transverse diameter of 39 per cent. History: The patient had had measles and pellagra in childhood, and "kidney trouble" at 17. She had received blood transfusions for anemia in the following years. At 22, she was treated for oliguria and dysuria; at 25-26, she had edema of the ankles and face. She had malaria and erysipelas of the leg when she was 27. Between 28 and 29, her vision began to fail; her physician told her that this was due to kidney disease. At 30, she had "something like a stroke" which cleared up after two or three weeks of bed rest. The patient had never been pregnant. One year before admission, she was treated with "injections" and blood transfusions for anemia, and with diuretics and other medication for hypertension and "kidney trouble." Her vision was poor; she complained of diplopia and scotomata. There was edema of the feet and legs. She had dyspnea on exertion, paroxysmal nocturnal dyspnea, a feeling of substernal oppression, tachycardia and palpitation. On examination, her height was 156 cm., her weight 82.2 Kg., temperature 37.5 C., pulse 88, respiration 20, blood pressure 190 systolic, 120 diastolic. Slight edema of the ankles and lower legs was noted. Extraocular movements were normal; the pupils were equal and reacted well to light and accommodation. Both discs were blurred on the nasal and temporal sides; the arterioles were silverish and moderately tortuous. A hemorrhage was present in the lower nasal region of the left eye. The teeth were carious, the tonsils enlarged. The lungs showed no pathological findings on percussion and auscultation. The heart was enlarged to the left and right; a soft systolic aortic murmur was heard. The abdomen was obese; no masses were felt, the liver was not enlarged, the spleen was not palpable, and no tenderness was present in either kidney region. The uterus was of normal size with a second degree retroversion. Neurological examination did not show any pathological findings. A chest film (fig. 35) was read: "Lungs clear. Heart enlarged." The transverse diameter of the heart was 16.7 cm. A flat plate of the abdomen and a retrograde pyelogram were reported as follows: "Kidney normal in outline, no stones seen. Calices and pelves on both sides normal. Spleen slightly enlarged." The electrocardiogram (fig. 36) showed a depressed RT segment in lead 1, diphasic Ti, and a normal sinus rhythm. The basal metabolic rate was —11 per cent. Accessory clinical findings: The hemoglobin was 92 per cent, red blood cells 4,-410,000, white blood cells 6,400 with 1 per cent non-segmented polymorphonuclears, 60 per cent segmented polymorphonuclears, 1 per cent basophils, 5 per cent monocytes, 6 per cent large lymphocytes, 27 per cent small lymphocytes; the corrected sedimentation rate was 18 mm. in one hour. Serological |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-006.pdf |
Document Sort | all; nchh-17 |
Article Title | Compensation Of Renal Metabolic Dysfunction Treatment Of Kidney Disease And Hypertensive Vascular Disease Ivith Rice Diet, Iii |
Article Author | Walter Kempner |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-006 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
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