The health question box

Renal Efficiency Q. Is there any means by which the effi­ciency of the kidneys may be determined? A. Normally the kidneys are able to do more than twice as much work as is needed to main­ tain life. Many persons have been able to live for years after the removal of one kidney. When the kidneys are diseased it is highly important to know if possible to what extent the disease has destroyed the kidney. This information may be obtained by a renal efficiency test. By means of recent discoveries it is now possible to determine with very great accuracy the efficiency of the kidneys, thus making it possible to judge of the degree to which the kidneys have been disabled by disease. This examination is of very great importance not only as an aid to prognosis but especially in surgical cases as a means of determining the ability of a patient to bear the administration of an anesthetic and of selecting the anesthetic to be used.

Origin of the Tapeworm Q. What is the origin of the tapeworm? A. The tapeworm is always due to the eat­ ing of flesh which has been imperfectly cooked. The embryos of the young tapeworm are found in little sacks or cysts in the lean flesh of beef or pork. The embryos of tenia solium may he seen with the naked eye, looking like small bladders in the lean meat of pork. In beef the cysts are too small to be readily seen with the unaided eye. Flesh containing these creatures is said to be "measly." This disease is very common in Ireland, where, according to good authorities, as large a proportion as three per cent of the hogs are affected. The disease is communicated to man by eating measly flesh without sufficient cooking to kill the embryos; hence it is most common among those who eat raw meat. Pork-packers and cooks are said to be most frequently affected with tapeworm, which is probably due to the habit of eating raw meat when about their work. Among the Abyssinian...

Tapeworm Q. What are the most prominent symp­toms of tapeworm, and by what means may the parasite be expelled? A. The most prominent symptoms of tape­ w orm a r e colicky pains in the lower part of th e abdo me n , e speci a lly a ft e r f as ting, relieved b y a f u ll me a l ; r a venous hunger, distention of the bowel with gas, alternate constipation and diarrhea, itching and prickling sensations; in children, convulsions; the passage of portions o f the worm . Of t he various symptoms just named the last is the only positive sign of the presence of tapeworm. No patient should ever be treated for tapeworm unless the positive signs of the presence of the parasite are first detected. The application of measures for expelling the worm must be managed by a physician. There are various remedies, but they should be used under the supervision of a competent medical man, as is true of the use of all poisons.

Symptoms of Trichinae Infection Q. What are the symptoms of infection with trichinae? A. At first the symptoms resemble those of cholera morbus , dysentery, or some other serious bowel disturbance. When the young worms be­gin to penetrate the system, the symptoms be­come more general, and simulate rheumatism, cerebro-spinal meningitis, typhoid fever, and other diseases . This is the reason why the malady is often o v erlooked. Indeed, there is reason for believing that the largest share of the cases of this disease are not detected. Whether or not death results, depends upon the number of parasites recei v ed into the system and the vitality of the patient. Death usually oc c urs from exhaustion, but may be caused paralysis of some of the muscles involved in respiration. The Unit e d States government has several times warned the public that pork should not be eaten without being thoroughly cooked on ac­count of the great frequency with which the hog is infected with this dis...

Trichina Q. Is the trichina a dangerous parasite? Is it found in other animals besides the hog? A. The trichina is usually found in pork, though it may infest the flesh of numerous other animals as well. Cases have been reported in England, in which it was found in calves. It has also been recently discovered in the hippopotamus. It exists only in the lean flesh of animals, and is found among the muscular fibres or enclosed in little sacs or capsules. When taken into the stomach by eating of flesh containing it, the worm is soon liberated from its capsular prison, and in the course of a week undergoes complete develop­ ment. It speedily brings forth young in im­ mense numbers, a single worm producing, it is stated, one thousand or more young. The young worms very quickly begin to penetrate the s y s­tem, either by boring their way through the in­testinal walls and thence to the muscles , their final destination, or by getting into the blood vessels and being swept along with t...

Worms Q. What is the cause and remedy for worms? A. The human alime ntary canal is subject to infection by several different species of worms. Some of these inhabit the small intes­tine and others the colon. No animal parasites of any sort locate themselves in the stomach for the reason that they are not able to withstand the digestiv e action of the gastric juice. The tapeworm which is perhaps the most common of these unwelcome tenants of the alimentary canal lives in the small intestine and the mucous membrane to which it attaches itself, obtaining its sustenance from the digested foodstuffs with which its body is bathed . Such an arrange ment is essential for the life of the tapeworm for the reason that it has no digestive organs of its own and hence can exist only at the expense of the digestive function of some other animal. Two varieties of tapeworm are found in the human body, one of which is derived from eat­ing infected beef, and the other from pork. The former specie...

Intestinal Bacteria Q. How do intestinal bacteria produce dis­ease? A. The disease-producing bacteria which de­ velop in the intestine produce their injurius effects through the poisons which result from their growth. These poisons are of two classes : First, those which are produced by the bac­teria while they are alive and which may be regarded as excretory products; second, those poisons believed by many to be still more virulent in character and consequences, known as en­dotoxins, which are formed within the bodies of the bacteria and are set free after death. It is probable that each species of bacteria pro­ duces its own special poisons, each of which produces specific effects upon the body, so that in reality each different species of these bacterial parasites may produce a different or specific dis­ease. At the present time bacteriologists do not possess sufficient knowledge of bacteria or their  products to be able to distinguish or designate the different for...

Intestinal Autointoxication Q. What is the meaning of the term "in­testinal autointoxication" and what are its symptoms? A. Intestinal autointoxication is a grave condition of the body which results from the absorption of poisons from the intestines. The source of the poison is putrefaction of undi­gested remnants of protein foodstuffs. Things which will putrefy outside the body will also undergo decay in the body. The conditions of the intestine are, in fact, specially favorable to promote putrefaction. A piece of raw meat applied next to the skin and covered will decay rapidly, and become extremely offensive within a few hours. The same piece of meat lying undigested in the colon or the lower part of the small intestine, will undergo the same change. The poisons produced are absorbed into the body and produce disturbances of various sorts. Intestinal autointoxication, resulting from the combined influence of chronic intestinal inac­tivity and the free use of flesh ...

Laxatives in Toxemia Q. Does clearing the bowels by laxatives lessen intestinal toxemia? A. An investigation conducted by Schulz (Berlin. Klin. Woch., June, 1900) shows that intestinal antiseptics diminish the ability of the intestine to destroy bacteria. After a dose of castor oil and calomel, cholera germs were found abundantly in the stools of dogs to whom cul­tures of this micro-organism had been given, while before the calomel was given no bacteria were found although large quantities of cholera germs had been introduced into the intestine in such a way as to avoid action by the gastric juic e. This experiment indicated that the in­ testine has in some way the power to destroy bac­ teria, probably, as suggested by Buchler, by means of a special ferment. Calomel interferes in some way with the action of this protective process

Intra-Abdominal Tension Q . What is intra-abdominal tension? A. If a small opening is made in the ab­dominal wall, the intestine quickly finds its way into the opening and is forced outward. This is the cause of hernia. There is maintained more or less constantly within the abdominal cavity a tension . This is necessary to support the large blood vessels which are found in this part of the body and also to promote movement of materials along the intestine and the dis­charge of waste matters from the body. This internal tension is of very great importance. It aids in regulating the circulation of blood and in various other functions, some of which are : 1. The tone of the intestinal wall. 2. The size of the intestinal canal. 3. Action of the intestinal muscles. 4. Pressure of the abdominal wall. 5. Pressure of the diaphragm during inspira­tion. 6. Gas distension of the intestines. Experiments have shown the great influence of variations of intra-abdominal pressure...

Short Circuiting of the Colon Q. What is short circuiting of the colon? A. In short circuiting of the colon, the small intestine is detached from its normal connection with the colon and is connected with the pel­ vic colon, the loop of the large intestine which joins the rectum. This operation, devised by Dr. Lane of London, has been performed in many cases for the purpose of relieving intes­ tinal toxemia or chronic constipation, and in some cases with apparent benefit, but unfortu ­ nately the benefit has in most cases proved to be only temporary and in many instances the patient has been made much worse than before. The operation is rapidly falling into disfavor among the best surgeons. Later experience has shown that the operation is rarely necessary for the following reasons : 1. By regulation of the diet, especially by the adoption of an anti-toxic or fleshless diet and by encouraging activity of the bowels through the use of sterilized bran, agar-agar and paraffin o...

Repair of Incompetent Ileocecal Valve Q. Can an incompetent ileocecal (ileocolic) valve be repaired? What is incompetency of the ileocecal valve? A. Fortunately this defect, which is now be­lieved to be responsible for many serious bodily ailments, may be completely repaired. It is also gratifying to note that the operation is safe and that the good results are likely to prove per­manent. Although the operation is comparatively re­ cent, several years have elapsed since the first cases operated upon and x-ray examinations have shown that the repaired valves still per­form their functions in a perfectly normal manner.

Recurring Appendicitis Q. Is an attack of appendicitis liable to make one susceptible to a second attack? A. Yes. Appendicitis doubtless begins in the colon. It is due to an extension of the infec­tion of the colon t o the appendix. When a person has had an attack of appendicitis, it is evi­dent that the colon is infected, and unless the colon is cured, the attack is likely to recur. There is no doubt, however, that by means of an anti­toxic diet and proper care to secure a thorough movement of the bowels two or three times daily, a person who has recovered from one attack of appendicitis need not have another unless the condition is quite unusual.

Appendicitis Q . Is an operation necessary in every case of appendicitis? A. A surgeon should be consulted in every c ase of appendicitis. Each individual case must be judged on its merits. Severe cases of ap­pendicitis require prompt surgical intervention. In cases of chronic appendiciti s the danger of a fat a l i ss u e i s much less than in a cute appen­dicitis, but the condition is one of too much gravity to be safely ignored. At the beginning of an attack, the bowels s hould be moved by a large enema containing a little soap or an ounce of sulphate of mag­ne s i a . A pp ly hot hip and leg packs every three h our s, with o n e or two ice-bags in the right groin c on t inuously. If the patient does not improve rapidly as a result of the thorough application of the above treatment, as shown by the lower temperature, a s lower pulse, and relief of pain, a thoroughly competent surgeon should be consulted. The most desirable time for performing an oper­ation in a case of...

The Appendix Q . Of what practical use is the appendix in the body? A. The appendix secretes mucus which lu­bricates the alimentary bolus, which is brought to the lower end of the caecum.

For Dry Stools Q. What is the best form of enema for very dry stools? A. W arm oil is best in such a case. Use from four ounces to half a pint of olive oil at a temperature of 109 ° F. Take care to see that the oil is perfectly sweet. Rancid oil might do much mischief. Hot soapsuds may be used in­ stead of oil. The solution of soap should not be so strong as to be irritating.

The Enema Q. Do regular daily enemas have a de­bilitating effect? A. Hot and warm enemas have a relaxing tendency. Cool enemas, that is, at a temper­ ature of 85° to 70°  F., have a tonic effect.

Examination of F e ces Q. Is it possible to obtain any important information concerning the condition of the body by examination of the stools or bowel discharges? A. The e xami n ation of the fec es is a most valuable me an s of diagnosis, e s pe c ially in cases of chronic disease; it is in fact a necessary part of the thoroughgoing investigation of a case. This examination not only determines the presence or absence of intestin a l para rasites, such as tapeworm, hookworm, amceba, etc., but indi­ cates the kind of bacteria present, and hence gives the key to the character of the fermenta­ tions taking place in the intestines, and the nature and amount of the bacterial toxins pro­ duced. Repeated at intervals of a week or two, it affords an opportunity to watch the gradual change of the intestinal flora from a noxious to a friendly sort, under the influence of an antitoxic diet and the use of antitoxic ferments.

Normal Color of the Feces Q. What is the normal color of the feces? A. The best example of the normal feces is to be seen in the discharges of a young infant, which are yellow in color and are either odor­ less or have a slight acid odor. When putre­faction is present the stool is usually black or brown in co lor and has a v ery offensive am­moniacal or putrid odor. The stools of adults generally have this appearance. In nearly all cases more or less putrefaction is present. By change of the flora the stool may be made to ac­quire an appearance closely resembling that of an infant.

Weight of Feces Q. What is the normal weight of the feces? A. The weight of the stool on a milk diet is rarely above 50 grams,-one and two-thirds ounces. The weight of the stool on a mixed diet is 50 to 300 grams, seldom under 100 grams. The more fruit and vegetables, the greater the weight of the stool. The daily stool in a vegetarian or fruitarian may weigh a pound or more.