Doris J. Place

Treatment of Nutritional Disturbances

The term nutrition has much broader implications than is generally appreciated. It implies not only the eating of foods, minerals, vitamins and the like, but also the food’s conversion into materials which the body can use. Finally, nutrition implies the way in which the body uses the material it digests to maintain growth, replacement, activity and good health. This includes, therefore, not only digestive processes in the intestine, but also metabolic processes all over the body, chemical and physical processes which are involved in maintaining the various physiologic activities of the organs and tissues of the body, and its constancy, or to use the presently more fashionable term, homeostasis. Nutritional diseases may be divided into dietary, electrolyte and metabolic disturbances.

The Use of Tranquilizers

The “tranquilizer” is a relatively recent addition to therapeutics. Though its meaning is by no means clear, there is already a long list of drugs to which the name is applied, and their use has spread like wildfire. While there are reports of death and disaster resulting from tranquilizers, there are also newspaper accounts of their sale on the black market and their illegal use for “kicks.” The medical and social problem created by these drugs is a serious one and is growing.

Administration of Drugs

The way in which a drug may best be administered depends on many factors: (1) whether a local or a systemic effect is needed, (2) whether the patient is conscious, (3) whether the patient is vomiting, (4) the characteristics of the drug itself which determine whether it may be given orally or must be given parenterally, (5) the safety of parenteral administration, (6) whether an emergency demands the most rapid method of obtaining effects regardless of dangers, (7) frequency of dosage.

Treatment of Urinary System Disorders

The urinary system consists of the two kidneys in which the urine is formed, the ureters which are thin tubes which conduct the urine from the kidneys to the urinary bladder, the urinary bladder in which the urine is temporarily stored and the urethra through which urine flows during urination. Because of the intimate association with the reproductive system there are some sex differences. In the male, the urethra leads through the prostate gland and penis and is relatively longer and thinner than the urethra of the female which leads directly from the bladder. In addition, the prostate gland lies in such a position that it may cause obstruction to the flow of urine through the urethra and prevent the complete emptying of the bladder; the female has no prostate gland or practical counterpart.

Factors Modifying Drug Action

The specific effect which drugs exert on certain organs may be altered in both intensity and rate of appearance and disappearance. This variance of drug action may be due to a number of factors not inherent in the drug itself. This chapter, therefore, deals with the following factors which modify drug action: (1) route of administration, (2) rate and degree of absorption, (3) rate of elimination, (4) effect of other drugs, (5) tolerance, (6) idiosyncrasy and allergy, (7) disease.

Treatment of Skin Disorders

The skin is a complex and important organ which functions to protect the tissues beneath from injury, irritation, infection and invasion. At the same time it is a responsive sensory organ and appreciative of many sensations: pain, itching, tingling, burning, hot and cold, pin-prick and two-point discrimination. As an organ it is capable of a variety of expressions in the form of symptoms, pain, itching, tingling, eruptions, color changes, swellings, blisters, postules, bullae and hives. The list of skin diseases is long and in a great many cases the cause is unknown. They may be due to irritation, allergies, infection, injuries, congenital defects, degenerative diseases, malignancies, drug reactions, intoxications, hormonal disturbances and emotional crises. Treatment is most effective when directed specifically against the cause of the skin disorder, but often this cannot be done. Skin symptoms are not only disagreeable to look at but can also be profoundly disturbing, so much so that in unrelieved intense itching a patient may attempt suicide. In addition, there are many serious skin diseases which drain one’s health and there are some which are fatal.

Treatment of Respiratory System Disorders

The respiratory system consists of the nose, paranasal sinuses (ethmoid, sphenoid, frontal and maxillary), larynx, tracheo-bronchial tree (trachea, bronchi and their smaller divisions), and lungs. The tracheo-bronchial tree conducts the inspired air from the nose and mouth to the lungs. Although the function of the paranasal sinuses is not clear, they may serve to provide moisture to the inspired air. The larynx contains the vocal cords and together with the rest of the respiratory system is concerned with the production of sounds and words. The act of breathing brings air into intimate contact with the blood circulating through the lungs so that gaseous exchange between them may take place.

Treatment of Reproductive System Disorders

The reproductive systems of the two sexes differ; in the male it is comprised of the testicles (or gonads), the seminal vesicles, the prostate gland and the penis; in the female it consists of the ovaries (or gonads), the fallopian tubes, the uterus and the vagina. The reproductive system is largely under the control of the endocrine glands of the body, especially the hormones produced by the pituitary gland. The reproductive function of the system combines a mechanism for sexual interest, potency and fertility, and a mechanism for the fertilization of the egg with the sperm, the harboring of the fertilized egg until it is ready for birth and the entire birth process. The gonads of each sex, in addition to providing the seed for fertilization, are also endocrine glands which tend to maintain the secondary physical sexual characteristics which externally distinguish the two sexes: the distribution of hair, the voice, the configuration of the hips, the texture of the skin, the development of functional breasts. When the gonads cease to function, the secondary sexual characteristics tend to change, and the individual so afflicted tends somewhat toward a neutral state.

Treatment of Neoplastic Diseases

The outstanding characteristic of neoplastic diseases, otherwise called newgrowths or tumors, is the tendency of certain groups of cells to increase in size. In the full-grown adult, all cells normally multiply slowly and at a rate approximately equal to that of the wearing out of old cells so that no growth or enlargement results. But in neoplastic disease some cells increase in number far beyond the needs for replacement so that growth in a particular spot or part of an organ goes on at an unusual rate and an enlargement or tumor develops. Thus, in a tumor or newgrowth of the thyroid gland, there is an excessive number of thyroid cells; in a tumor of the prostate there are too many prostate cells. Comparable situations develop in the blood-forming organs, an excessive number of red blood cells leads to a condition known as polycythemia and an excessive number of white blood cells causes leukemia.

Treatment of Infections

The oldest as well as the most elusive problem in the history of the treatment of disease has been that of driving out the cause of disease. Obviously, the first information needed, and until recently lacking, was knowledge of the cause. Long before it was understood what the nature of infectious agents truly was, their infectious character had been recognized. Since it was realized that certain diseases could be transmitted from one human to another this in turn implied that some invisible disease-producing force was causing the infection. Originally the invasion of the human host and the transfer of disease to another was consigned to supernatural forces, and treatment designed accordingly. When natural and tangible forces, such as bacteria and other forms of microscopic life, were identified as the causes of many diseases it became possible to examine their characteristics and means of transmission. The problems of treatment were more clearly delineated when studies demonstrated that disease-producing micro-organisms shared many of the properties of higher forms of life.