Studies in Infantile Gastro-Enteritis

Berkeley, Joseph (1947) Studies in Infantile Gastro-Enteritis. PhD thesis, University of Glasgow.

Abstract

The Thesis has been divided into three parts. In Part 1. an account has been given of early historical references to gastro-enteritis in infancy. Recent work on epidemiology and treatment has been reviewed. In Part 2. certain clinical aspects have been investigated under the following headings: (a) Oedema. Oedema has been found to occur in 35 cases out of 176 cases of infantile gastro-enteritis investigated. The oedema was confined to patients in the 0-16 months age-group and was never observed before the 5th day of illness. The oedema subsided spontaneously, in most cases its duration being from 2-8 days. Weight-changes which accompanied the oedema, were found to fluctuate parallel with the rise and fall of the visible oedema. Several oedematous patients were found to have a microcytic hypochromic anaemia, but none showed signs of albuminuria, heart disease,macrocytic anaemia, or Vitamin B. deficiency. The oedema was not related to the giving of excessive parenteral fluid or to sulphonamide therapy. Experimentally, it was found that protein feeding had no effect in reducing the incidence or duration the oedema. The mortality in oedematous patients was 31. 4% and in the non-oedematous, 17.7% Hypothetical explanations for the condition have been discussed. Of these, the likeliest has been considered to be one or a combination of the following:-impairment in capillary function, impairment in liver function and impairment in renal function. (b) Evacuation Time. The time taken for food to pass through the alimentary tract in patients suffering from acute gastro-enteritis, has been investigated by administering charcoal orally and noting the time when it first appeared in the stools. The findings have been compared with those in a number of similar children not suffering from, gastro-enteritis. The results indicate that in gastroenteritis, this evacuation-time is much reduced: in one patient the charcoal appeared in the stool in only two hours after its ingestion. There was wide variation in evacuation-times in individuals in both groups, and all infants investigated showed charcoal residues in the stools for 36 - 96 hours after its first administration. The findings for normal infants have agreed with those of other investigators who used different methods of estimation and it has been concluded that the charcoal method was a reasonably accurate and convenient means of determining the evacuationtime . (c) Intra-Gastric Drip Feed. A method of intra-gastric drip feeding has been described for the treatment of vomiting and dehydration in infantile gastro-enteritis. The procedure is free from the disadvantages of parenteral therapy. It has been found simple, safe and effective. Some original points in the technique have been described and recommended for facilitating administration. In Part 3. the bacteriological findings in infantile gastroenteritis have been reviewed and discussed. The occurrence of a certain strain of coliform bacilli, Bact. coli. neapolitanum, recently suggested to be of aetiological importance in the condition, has been investigated bacteriologically and serologically. This organism was found not to occur in a significant proportion of the cases investigated, although statistical analysis revealed a significant association with mortality and a possibly significant association with duration of illness. This organism was found also in children suffering from diarrhoeal diseases of known specific aetiology, but not in healthy controls. The findings have been reviewed statistically and the general implications discussed.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Keywords: Medicine
• Date of Award: 1947
• Depositing User: Enlighten Team
• Unique ID: glathesis:1947-79646
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 04 Mar 2020 16:17
• Last Modified: 04 Mar 2020 16:17
• URI: https://theses.gla.ac.uk/id/eprint/79646