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March, 1945 RICE DIET—KEMPNER 143 had to give up his work as a painter. During all of 1944, he was conscious of a smothering sensation when he was walking or lying flat in bed. He noticed occasional puffiness around the eyes, increasing weakness, and blurring of vision. He was told that he had high blood pressure (220 systolic), kidney disease, and anemia. After "several blood transfusions and liver injections" he felt temporarily "stronger," but there was no improvement in the anemia, and his blood pressure remained high. In May, 1944, his physician placed him on a slightly modified rice diet. However, after an attack of dys-uria, frequency, and back pain, the diet was discontinued. Further blood transfusions were given (making a total of nine) as well as vitamins, iron, and sedatives. For two weeks preceding admission, he had considerable distress from "throbbing headaches," dizziness, and tinnitus. Examination: The patient's height was 180 cm., his weight 71.2 Kg., temperature 37 C., pulse 88, respiration 22, blood pressure 250 systolic, 130 diastolic. He was a well developed, pale man who appeared chronically ill and had a strongly uremic odor. There was no edema. The pupils reacted well to accommodation and light; the discs were blurred, and the arterioles tortuous; silvery and cottony exudates were scattered throughout both fundi. The nasal sep- tum was deflected and breathing space was inadequate bilaterally. Several teeth were carious; the tongue was coated, the tonsils moderately enlarged. The lungs were clear. The heart was enlarged to the left. A blowing apical systolic murmur was heard, and the aortic second sound was accentuated. The liver was felt at the costal margin and descended two fingers' breadth on deep inspiration. The spleen was not palpable. There was no tenderness in either kidney region. Accessory clinical findings: The hemoglobin was 53 per cent, red blood cells 2,490,-000, white blood cells 7,280 with 71 per cent segmented polymorphonuclears, 1 per cent eosinophils, 28 per cent small lymphocytes. The corrected sedimentation rate was 10 mm. in one hour, the reticulocyte count 0.6 per cent, the hematocrit reading 17.4 volumes per cent. Serological tests for syphilis were negative. The nonprotein nitrogen was 156-174 mg. per 100 cc. of blood, the urea nitrogen 105 mg.; the blood sugar was 112 mg. per 100 cc. Chlorides (as sodium chloride) were 544 mg. per 100 cc. of plasma; calcium was 8.0 mg. per 100 cc. of serum, phosphorus 7.3 mg., cholesterol 295 mg. The total proteins were 6.8 Gm. per 100 cc. of plasma: albumin 4.0 Gm., globulin 2.8 Gm., albumin-globulin ratio 1.4. The urine contained 60-75 red blood cells and 1-2 white blood cells per high power field, occasional 11-3-44 228/135 MM.HG. 1-9-45 165/104 MM. HG. 15.1 cm. 33.7 cm. 33.4 cm. 13.8 cm. Fig. 46. J.K. Terminal uremic stage of chronic nephritis. Rice diet started November 1, 1944. No digitalis. Reduction in heart size with change in transverse diameter of 9 per cent. Right side of ascending aorta less bulging.
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 143 (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-17-006-0155 |
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_0155.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 | 143 |
Health Discipline | Medicine |
Full Text | March, 1945 RICE DIET—KEMPNER 143 had to give up his work as a painter. During all of 1944, he was conscious of a smothering sensation when he was walking or lying flat in bed. He noticed occasional puffiness around the eyes, increasing weakness, and blurring of vision. He was told that he had high blood pressure (220 systolic), kidney disease, and anemia. After "several blood transfusions and liver injections" he felt temporarily "stronger" but there was no improvement in the anemia, and his blood pressure remained high. In May, 1944, his physician placed him on a slightly modified rice diet. However, after an attack of dys-uria, frequency, and back pain, the diet was discontinued. Further blood transfusions were given (making a total of nine) as well as vitamins, iron, and sedatives. For two weeks preceding admission, he had considerable distress from "throbbing headaches" dizziness, and tinnitus. Examination: The patient's height was 180 cm., his weight 71.2 Kg., temperature 37 C., pulse 88, respiration 22, blood pressure 250 systolic, 130 diastolic. He was a well developed, pale man who appeared chronically ill and had a strongly uremic odor. There was no edema. The pupils reacted well to accommodation and light; the discs were blurred, and the arterioles tortuous; silvery and cottony exudates were scattered throughout both fundi. The nasal sep- tum was deflected and breathing space was inadequate bilaterally. Several teeth were carious; the tongue was coated, the tonsils moderately enlarged. The lungs were clear. The heart was enlarged to the left. A blowing apical systolic murmur was heard, and the aortic second sound was accentuated. The liver was felt at the costal margin and descended two fingers' breadth on deep inspiration. The spleen was not palpable. There was no tenderness in either kidney region. Accessory clinical findings: The hemoglobin was 53 per cent, red blood cells 2,490,-000, white blood cells 7,280 with 71 per cent segmented polymorphonuclears, 1 per cent eosinophils, 28 per cent small lymphocytes. The corrected sedimentation rate was 10 mm. in one hour, the reticulocyte count 0.6 per cent, the hematocrit reading 17.4 volumes per cent. Serological tests for syphilis were negative. The nonprotein nitrogen was 156-174 mg. per 100 cc. of blood, the urea nitrogen 105 mg.; the blood sugar was 112 mg. per 100 cc. Chlorides (as sodium chloride) were 544 mg. per 100 cc. of plasma; calcium was 8.0 mg. per 100 cc. of serum, phosphorus 7.3 mg., cholesterol 295 mg. The total proteins were 6.8 Gm. per 100 cc. of plasma: albumin 4.0 Gm., globulin 2.8 Gm., albumin-globulin ratio 1.4. The urine contained 60-75 red blood cells and 1-2 white blood cells per high power field, occasional 11-3-44 228/135 MM.HG. 1-9-45 165/104 MM. HG. 15.1 cm. 33.7 cm. 33.4 cm. 13.8 cm. Fig. 46. J.K. Terminal uremic stage of chronic nephritis. Rice diet started November 1, 1944. No digitalis. Reduction in heart size with change in transverse diameter of 9 per cent. Right side of ascending aorta less bulging. |
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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