COMPLIMENTS OF THE AUTHOR. 
LITH^MIA 
AS AN 
FACTOR IN DISEASE, 
AND THE USE OF 
ALKALITHIA 
IN THE TREATMENT OF THE SAME. 
A. B. CONKLIN. M. D. 
THROUGHOUT the following pages the word Lithaemia is 
used in the broadest acceptation of the word ; as a conve- 
nient term, in the absence of a better nosology, to cover that 
broad condition of feeble digestion, faulty assimilation, imperfect 
metabolism and insufficient renal elimination, which leads to an 
accumulation in the system of uric acid and the urates ; the 
application of the term was first made by Murchison. It implies 
a diatheses, not a single disease. 
Lithiasis, gouty diathesis and uric acid diathesis are synony- 
mous terms. Uric acid as a pathological factor belongs to the 
group of nitrogenous toxines, and thus lithaemia may be defined 
as autointoxication. However, it should not be confounded with 
uraemia, which denotes a state of autointoxication from urea. 
Lithaemia is uric acidaemia or uricaemia, though either term 
is too bungling to ever come into general use, and if it be borne 
in mind that lithic acid is another name for uric acid the word 
lithaemia, it will be seen, is equally comprehensive, and to be 
preferred. 
Believing that the relationship between lithaemia and the list 
of diseases which the writer attributes to it as a common cause, 
will be more easily discerned as the late writings of Prof. A. Haig, 
of London, are more carefully studied, we take the liberty of 2 
ALKALITHIA IN LITH/EMIA. 
summarizing some of ms recent provings for the benefit of those 
who haven’t his work. 
Being himself a sufferer from lithaemia his opportunities for 
observation have been unsurpassed, and when coupled with his 
exact methods of investigating the effects upon the human system 
of accumulations of uric acid, his deductions appeal to our intelli- 
gence for recognition as verified facts. 
FIRST. He has demonstrated to a mathematical certainty 
that, the amount of uric acid formed in the system bears a direct 
relationship to the amount of proteid food consumed, destructive 
metabolism remaining unchanged. 
SECOND. Under a condition of normal alkalescence of the 
blood this fluid conveys uric acid in a state of solution to the kid- 
neys, where it is eliminated as fast as formed, this being nature’s 
method of removal. 
Third. Under conditions of diminished alkalinity of the 
blood, which less readily holds uric acid and its salts in solution, 
the only form favorable for elimination, this substance is pre- 
cipitated out of the blood into tissues having a greater affinity for 
it, as the liver, spleen, cartilages of joints and fibrous tissue, 
which Sir A. Garrod has shown to more often contain appreciable 
quantities of uric acid, than other tissues of the body. 
FOURTH. As the alkalescence of the blood is a constantly 
fluctuating factor, being influenced by every meal and numerous 
other causes, there are frequently recurring periods of uric acid 
retention, of variable duration, which retained or stored up uric 
acid is again carried into the general circulation whenever an 
incidental cause again increases the alkalescence of the blood to 
a point that will hold uric acid in solution, and once more it is on 
its way to the kidneys for elimination. 
FIFTH. The precipitation of uric acid or urates into the 
fibrous tissue of joints constitutes true gout and when found else- 
where in fibrous tissue as in sheathes and intermuscular septa of 
muscles we get rheumatism. 
SIXTH. I wish to call the attention of the reader to the uni- 
form results which were shown to follow whenever carefully 
conducted quantitative estimations of the amount of uric acid 
passing the kidneys showed an abnormal amount circulating in 
the blood. In the first place it should be remembered that the 
amount of uric acid excreted was carefully estimated several ALKALITHIA IN LITH/EMIA. 
3 
times a day, for weeks and months, and a careful record kept of 
the ha?mic alkalinity as modified by animal, mixed and vegetable 
diets, sour wines, ale and beer. 
It was found that, upon the ordinary mixed diet, there were 
periods of several hours or days duration in which there was a 
subnormal excretion of uric acid occurring simultaneously with a 
lowered alkalinity of the blood, and whenever the alkalinity of 
the blood was allowed to reach its normal point, there was a free 
output of uric acid again, many times greatly in excess of the 
normal daily average. 
SEVENTH. Aside from proving the periodical retention of 
uric acid it was invariably observed that, whenever there was a 
periodical retention, at which times he argued it was not circulat- 
ing in the blood, and thus being brought in contact wi'h the 
nervous system, there was a condition of mental brilliancy, 
acuteness of intellect, and a general feeling of well-being, accom- 
panied with a full, soft pulse, and lowered arterial tension, as shown 
by the sphygmograph. Conversely, an increasing alkalinity of 
the blood, by inviting the stored-up uric acid again into the cir- 
culation, as shown by the increasing amount in the urine, pro- 
foundly influenced the nervous system until the excess was gotten 
rid of, as manifested by mental depression, despondency, melan- 
cholia, irritability of temper, and, above all, a small, hard pulse 
and increased arterial tension. 
The small, hard pulse, with increased arterial tension, shows 
a contraction of the systemic capillaries and peripheral arterioles 
which is brought about through stimulation of the vaso-motor 
centres in the medulla. 
In short, we have but to apply the physiology of the sym- 
pathetic in its vaso-motor fibres to explain the whole philosophy 
of Prof. Haig’s findings; and the reader is urged, throughout the 
pages which follow, to bear in mind the primary disturbance of 
the cerebral centres, with secondary perversion in vaso-motor 
innervation, which follow upon an abnormally large amount of 
uric acid circulating in the blood. 
Uric acid is an irritant to the nerve centres, but not all 
people have nerve centres equally endowed with the quality of 
receptivity, and herein lies an explanation of the immunity of 
some people from lithamiic troubles, though circulating an amount 
of uric acid that would overpower others. 4 
ALKALITHIA IN LITH/EMIA. 
Uric acid may operate to set up a morbid condition in one of 
three ways, and for this reason we find a natural classification of 
lithaemic diseases into three groups: (i) Those representing a 
deposition of uric acid in cartilaginous and fibrous tissue, as gout 
and rheumatism. (2) Those conditions set up by uric acid as an 
excrementitious solid, in its passage along the urinary organs, as 
gravel, cystitis, Bright’s disease, etc., these first two groups 
representing the local irritant action of uric acid. (3) Those 
diseases brought about through the medium of innervation and 
representing the indirect action of uric acid while circulating in 
the blood — the functional neuroses. 
The development of a functional neurosis in a case of 
lithasmia depends upon the impressibility of the nerve centres, 
and from this we deduct the rule that, given an excess of uric 
acid in the blood, pathological results will follow in an inverse 
ratio to the power of resistance of the nervous system. 
The American people as a race have, not untruthfully, been 
called “a nation of dyspeptics,” and this factor (along with the 
fact that our overstimulating manner of living, and rapid methods 
of business, entailing unceasing care and worry in those often 
handicapped by an inheritance rich only in neuropathic tendency, 
have given us a nervous endowment rendering us peculiarly 
susceptible to all influences operating on the nervous system) 
leaves us doubly exposed to the invasion of lithaemic troubles. 
In fact, we fear it may be recorded to the discredit of the 
American profession that the penetrating intellect of London’s 
immortal practitioner, J. Milner Fothergill, saw more .clearly ten 
years ago the conditions surrounding us than we ourselves 
see them to-day, when, in delivering a lecture upon “The 
Neurotic with Indigestion and Lithiasis,” he said, “The subject 
is one which must possess a high interest for American physi- 
cians, for the excellent reason that they must so constantly 
encounter it.” 
“ O ! wad some power the giftie gie us.” 
Morris H. Henry, M.A., M.D., LL.D., of New York, in a 
recent article upon gout, in speaking of the prevalence of that 
diathesis, says: “There can be no doubt that the errors in diet 
and the tendency to overeating in this country is leading to the 
development of gout in a large class of our population. It is now ALKALITHIA IN LITHzEMIA. 
5 
a mere question of time when the gouty diathesis shall be mani- 
fested here as fully and as frequently as in other countries, 
where it has prevailed for centuries.” 
Dr. Meigs, of Philadelphia, says: “In a great majority of 
cases, where children worry without apparent reason, the origin 
of their distress is a lack of water to wash away the products of 
tissue change.” 
While other theories have not been found wanting, from the 
inception of medical literature to the present day, to account for 
the development of gout and its congener, rheumatism, yet I take 
it for granted that the consensus of opinion among medical men 
of to-day is that they are the most common manifestations of 
lithmmia ; and with this simple statement of an accepted fact 
I will pass the discussion of their aetiology and pathology and take 
up their treatment with Alkalithia. 
I think it will be admitted as an axiomatic truth that where 
the cause of a disease is known, the best treatment of that 
disease is to seek to remove the cause, if still operative; and, if 
the cause of gout and rheumatism be uric acid, clearly, then, the 
best treatment of these conditions is to remove from the system 
uric acid. If there is any more radical or effective method than 
by the use of the “alkaline treatment,” I don’t know of it. 
A condition most favorable to the elimination of uric acid, is 
one of increased haemic alkalinity, with diuresis. 
An excellent remedy to induce this condition is “Alkalithia;” 
a remedy which contains five grains of Carbonate of Lithia and 
ten grains each of Bicarbonate of Soda and Potash to each dram, 
or a total of twenty-five grains of alkali to each dose of a dram 
or heaping teaspoonful, in combination with Caffeine, which has 
been called by some of our therapeutists, “the ideal diuretic.” 
Those who have given it a fair trial, combined as above in 
“Alkalithia,” find it as effective in practice as it was held to be 
ideal in theory. 
Common cases in the practice of every physician are those 
belonging to our second group of lithsmics, viz.: Those cases due 
to the irritative influence of uric acid upon the urinary organs. 
These patients complain of “lame back,” “crick in the back,” 
“kidney complaint,” and “rheumatism of the back.” 
They have pain, soreness and tenderness across the loins 
and back of the hips and down the sciatlcs. They have a char 6 
ALKALITHIA IN L1TH/EMIA. 
acteristic pain extending diagonally from the kidneys through the 
body to the bladder. It is along the course of the ureters and is 
pathognomonic of the passage of urinary solids in a state of 
concentration, the intensity of the pain indicating the degree of 
condensation from urine with a high sp. gr., to gravel and cal- 
culus. 
They squat, from preference, and bend over when they have 
to, for they straighten up with difficulty and by degrees. The 
body is carried slightly bent and the gait is slow, each step being 
taken with caution to avoid jarring the kidneys. 
These patients pass a urine that is scanty, high colored, of 
high sp. gr. and which on cooling throws down a crystalline 
deposit. The picture is not overdrawn. It gives a correct view 
of inflamed kidneys and ureters from lithasmic urine. 
Alkalithia is the best remedy for the above condition that 
we have ever tried. It increases the alkalinity while at the same 
time it augments the bulk of the urine, thereby holding the solids 
in solution and flushing them out of the body. Such cases are 
cured by the use of . 
When the force of the urinary irritant is spent upon the 
bladder these patients suffer every degree or pain rrom the slight 
irritation that necessitates their rising at night to void their urine, 
to the misery of cystitis with vesical spasm. In every case of 
frequent urination with smarting, scalding, or burning of the neck 
of the bladder, urethrea, the vulva in the female or the prepuce 
in the uncircumcised male, look carefully to the condition of the 
urine, and give “Alkalithia” with full assurance that your 
joatient will be benefitted. 
A urine containing a high percentage of uric acid means irri- 
tation of the neck of the bladder. Irritation of the neck of the 
bladder means frequent calls to urinate. Frequent calls to 
urinate occuring in a child that slumbers on midst dreams 
of waking gives us a case of enuresis. This frequent and unusual 
desire to pass water during the night, Prof. Dowling says may be 
the first symptom to attract the attention of the incipient lith- 
aemic. These cases are benefitted at once by the use of “Alka- 
lithia,” which dissipates the cause. The alkaline treatment of 
bed-wetting in children is nothing new, having been mentioned 
by the writer in a paper read before the State Association nine 
years ago, at its meeting at Detroit. ALKAUTHIA IN UTH/F..MIA. 
7 
The mother who stints such a child in the use of water, so it 
will not make so much urine, and possibly can hold its urine 
until morning, is but enforcing a fool’s philosophy, for is not a 
lack of water to hold the solids in solution and wash them from 
the system, a cause of the irritating urine ? 
At the meeting of The Association of American Physicians 
in 1886, at Washington, D. C., Prof. James Tyson, of Philadel- 
phia, opened a discussion upon the question : “ Does the present 
state of our knowledge justify a clinical and pathological correla- 
tion of rheumatism, gout, diabetes and chronic Bright’s disease ? ” 
The question was ably discussed pro and con, the diseases 
were admitted to have pathological points in common, to be still 
more closely related clinically, and the belief was prevalent that 
the revelations of vital chemistry would, in time, lead us to view 
them as but so many manifestations of one and the same under- 
lying systemic condition. Hear- what J. Milner Fothergill 
says of uric acid influence in the causation of Bright’s disease. 
In the course of a series of lectures delivered ten years ago, at 
his house in London, England, upon the subject of “The Modern 
Tendency of Disease,” he says: “We have of late years been 
studying disease, rather than the individual, and the forces 
external and internal operating upon him. The battle of life now 
is fought with the brain, and the strain upon the nervous 
system leads to visceral derangements. The digestion is impaired. 
Meat is largely eaten by town dwellers, because it is easily 
digested in the stomach. The consequence is, the liver is over- 
taxed and reverts to the uric acid formation. This leads to 
changes in the vascular system and the kidneys, known as 
chronic Bright’s disease. The effect of brain toil in the produc- 
tion of diseases connected with hepatic inadequacy, is seen in 
the prevalence at the present time of diabetes and chronic 
Bright’s disease.” 
Again he says: “When the urine of an animal, possessing 
a four-chambered heart and a fluid urine, deposits, on cooling, a 
quantity of urates—the form of urinary excretion belonging to 
animals with a three-chambered heart and a solid urine—depend 
upon it, the will suffer sooner or later for this reversion 
on the part of the liver. Human kidneys are not constructed to 
excrete the comparatively insoluble urates, and if they have to do 
so for a continuous time, they become injured. If the urates are 8 
ALKALITHIA IN LITH/EMIA. 
formed in large or considerable quantity, one of two things must 
occur: (i) The kidneys are injured, or (2) The urates are 
retained in the system as gout. The first gives Bright’s disease; 
the second, gout in some form. Often the condition is a blend 
of the two.” 
The direct testimony of one like J. Milner Fothergill, than 
whom probably no higher authority exists upon the subject of 
lithasmia, hailing from the land of gout and affirming in unequivocal 
terms the common parentage of gout, rheumatism, diabetes and 
Bright’s disease, leaves little to be said by one who would repudi- 
ate the theory or attempt to disprove the facts. 
My own experience in practice, since I first had my attention 
drawn to the lithaemic origin of diabetes and Bright’s disease by 
reading Dr. Fothergill’s strong language ten years ago, but con- 
firms the teachings of this medical savant and teaches me 
furthermore that these diseases in their incipent stages may be 
permanently cured by such alkali remedies as Alkalithia. 
Why does Alkalithia do so much for these diseases ? Be- 
cause the lithia and other alkalies in it neutralize uric acid and 
bear it out of the system and thus get rid of its direct irritating 
action upon the kidneys in setting up Bright’s disease on the one 
hand, and its secondary or indirect action in disturbing vaso- 
motor innervation and fostering diabetes on the other hand. 
Alkalithia is the remedy par excellence for the treatment of these 
diseases in their early stages: 
Nervousness, Irritability of Temper, Emotional Insanity, 
Melancholia and Dementia. 
I wish especially to call the attention of the profession to the 
use of Alkalithia in the treatment of the functional neuroses. 
Although an entirely different line of treatment is usually 
thought of in managing these cases, yet if their litfuEmic origin 
be borne in mind, this at once suggests the use of Alkalithia. 
Referring again to the provings of Prof. Haig, as enumerated 
in our summary on page three, section seventh, it will be observed 
that whenever uric acid is accumulating in the system there is to 
be seen a condition of mental brilliancy, vivacity of spirits, 
acuteness of intellect, exalted energy, unusual endurance and a 
general feeling of well-being, and whenever this excess is pass- 
ing away (at which time Prof. Haig argues it is being brought in 
contact with the nerve centres by being in the blood), there is ALKALITHIA IN LITH/EMIA. 
9 
undue nervous tension. The patient then is irritable, snappish, 
sarcastic, easily annoyed, despondent, melancholy, has the blues, 
petty annoyances seem exasperating trials and ordinary daily 
duties become irksome tasks. 
These patients suffer every degree of mental perversion 
from irritability of temper to emotional insanity; from the blues 
to dementia. These cases of nervousness constitute one of the 
most common phases of lithaemia, and such cases are completely 
cured by the proper and systematic use of Alkalithia. 
At times this disturbance of the nervous system comprises 
all there is of the case, beyond the lithaemia, while in other 
cases this nervous condition, though nevertheless a significant 
feature, is obscured by some more conspicuous symptoms. What- 
ever the particular name may be that defines the diagnosis is 
immaterial, but one of the best remedies that 1 have ever used 
for the cure of all those cases of nervousness is Alkalithia. The 
relief is prompt and the cure complete by continuing the remedy 
for a short time. 
INSOMNIA. 
The same high nervous tension that begets nervousness and 
irritability often prevents a patient from sleeping, and nothing 
then acts with more curative effect than Alkalithia. 1 have seen 
most excellent results follow its administration in breaking up 
that condition of wakefulness that makes a nightly dose of some 
nectar as an offering to Morpheus a necessity. 
IRREGULAR ACTION OF THE HEART. 
This is another condition that supervenes upon perverted 
cerebro-spinal innervation growing out of lithaemia. In the ab- 
sence of prominent gastric symptoms to account for the disturbed 
heart action, these cases are liable to be mistaken for organic 
disease, but an examination into the matter of renal elimination 
shows they are laboring under a state of uric acid intoxication, 
and alkaline treatment by Alkalithia in my hands has in a con- 
siderable number of cases, demonstrated that they get better 
rapidly as they get rid of uric acid. Alkalithia is a remedy for 
these cases that leaves nothing to be desired. It is to be relied 
upon, and if it is used rarely will any heart “ regulator ” be 
required. Think of Alkalithia, in your next case of irregular 
heart action, especially if there be a circumscribed area of sore- 
ness over the region of the heart. 10 
ALKALITHIA IN LITH/EMIA. 
NEURASTHENIA. 
Passing now to the spinal neuroses we find that neurasthenia, 
or “Americanaemia” as it has not inappropriately been called, 
is a disease which in some cases tells of a lithasmic state. 
Hammond calls it “spinal irritation,” and defines it as pos- 
terior spinal anaemia, and further says: “Now that the function 
of the sympathetic nerve as regards its action in regulating the 
calibre of the blood vessels is so satisfactorily proven, we can 
partially understand how local congestions and anaemias may be 
superinduced. It is probable, therefore, that the original dis- 
turbance in many cases of spinal irritation resides in the sym- 
pathetic system.” 
The localized ischaemia is purely vaso-motor in origin, and 
grows out of the irritating influence of uric acid upon nerve cen- 
tres. Though localized in the spine this is in its origin a vaso- 
motor neurosis. The writer has seen a few cases where the 
lithaemic phase of the case was very marked, and the use of 
alkaline treatment in these cases does more for them than any- 
thing else. 
Where the systemic condition of lithaemia is present in 
neurasthenia, use Alkalithia in preference to any other remedy, 
and you will not be disappointed. 
What is true of neurasthenia as a localized display of a per- 
version of vaso-motor innervation, is also true of 
Each is a localized spinal ischaemia. The one is posterior, the 
other anterior. One deals with a sensory tract, the other with 
a motor tract. 
1 recall one case in particular of locomotor ataxia that de- 
veloped in an obese lithaemic who had had a scanty, heavy urine 
for years. Alkalithia relieved him to a very great extent, but 
being in an advanced stage of the disease, he was not cured. 
If taken in its incipient stages, I believe Alkalithia will stay the 
development of ataxia. 
PROGRESSIVE LOCOMOTOR ATAXIA. 
What is hysteria? It is a neurosis, and while it may grow 
out of uterine or ovarian troubles, the time is past when a con- 
dition of hysteria necessarily means a wrong of the female gen- 
erative organs. 
HYSTERIA. ALKALITHIA IN LITH/EMIA. 
11 
Hysteria is distorted innervation. It may come from any 
cause that shocks, depresses, over-stimulates or irritates the 
nervous system, either in the male or female. 
It has been my experience to see a few well-marked cases 
of high nervous tension growing out of lithaemia, culminating in 
hysteria. To these cases AI kalithia is as near a specific as 
quinine is to ague. 
This is another disease that should be classed among the 
functional neuroses. It consists of a loss of the power of co- 
ordination of muscular movements. The centre which presides 
over this function is located at the base of the brain, in the 
medulla. Irritation of the medulla then by uric acid may cause 
choreic movements. 
Van der Kolk thinks “the virus of chorea is so closely 
related to that of rheumatism that either form of the disease may 
be caused by it.” 
Germain See says, “ Chorea is almost always of rheumatic 
origin,” and Duckworth says, “ Chorea is merely a manifestation 
of rheumatism.” 
Its association with rheumatism has been recognized for 
centuries. That the alkaline treatment will cure chorea, / do 
know, having cured a case in the spring of 1889 by acetate of 
potash alone. It being a case where the Iithaemic diathesis was 
very pronounced, I began treatment by medicating the patient 
for the diathesis first, when the improvement in the choreic 
movements was so pronounced I concluded to make a test case 
of it, and see to what extent recuperation would follow upon a 
mere depurative plan of treatment. 
My patient gradually regained control over his movements 
up to the point of complete restoration of co-ordination. No 
other remedy than acetate of potash was used. Bear in mind 
that your choreic patient is more than likely a litha?mic patient, 
and if so, you can find nothing that will relieve more effectually 
or scientifically than Alkalithia. 
Nine years ago in writing of uric acid the author spoke of 
the characteristic headache of litha?mia as being low down in the 
base of the brain, and producing a desire to draw the head over 
back. This headache is in that portion of the brain which 
presides over the functions of animal life. It is irritation of the 
CHORHA. 12 
ALKALITHIA IN LITH/EMIA. 
medulla and basilar brain, and because this portion of the brain 
contains the centres of animal life it will be readily seen why 
lithasmia originates so mhny of the neuroses which show a per- 
version of the functions of animal life. 
ENURESIS. 
Though I have shown how this condition may come from the 
local irritant action of uric acid upon the bladder, yet it may 
develop as a neurosis. 
Harkin’s theory of enuresis is that it comes from irritation 
of the medulla, and he claims to cure all cases by applying a 
blister to the nucha. If irritation of the medulla will cause 
enuresis, then it becomes a neurosis, and the influence of uric 
acid upon the medulla may produce it. I have applied Dr. 
Harkin’s treatment in but one case, and while the results were 
good, 1 cannot now say if it was a lithasmic, but Alkalithia will 
cure some cases of enuresis, as I have previously pointed out. 
Whether it is by relieving the medulla or the bladder/or 
both, I will not pretend to say. 
EPILEPSY. 
All agree in calling epilepsy a neurosis. There is not a 
uniformity of opinion, however, as to whether it be functional or 
organic. 
Reynolds, of London, pointed out among the pathological 
conditions fairly well established, that the seat of the primary 
derangement is the medulla, and consists of “an increased and 
perverted readiness of action in the part, the result of such 
action being the induction of spasm in the contractile fibres of 
vessels supplying the brain.” 
Nothnagel tells us that the centre for consciousness is in the 
medulla and that for the muscular system in the pons, and thus 
accounts for loss of either function independent of the other. 
Echiverria, confirming the conclusions of Scroeder von der 
Kolk, has shown the lesions in the medulla to be constant 
changes in epilepsy. 
Among those who have carried on pathological experiments 
in the study of epilepsy, Kusmall and Tenner have shown that 
irritation of the medulla, which is known to be the origin of the 
great sympathetic, gives rise to spasm of the cerebral vessels, 
with consequent anaemia, and that anaemia of the brain causes ALKALITHIA IN LITH/EMIA. 
13 
loss of consciousness and convulsions. These opinions are held 
by Althaus and Brown-Sequard. From these provings they draw 
the conclusion that the medulla is the seat of epilepsy. 
If, then, the phenomena we call epilepsy may come from 
localized cerebral anaemia—ischaemia—why may not a disturb- 
ance of vaso-motor innervation originate it ? Uric acid will 
furnish the disturbance. Hammond calls attention to the fact 
that “continued and excessive indulgence in animal food is 
likely to predispose to the disease in some persons.” 
Portal has recorded several cases where persons became 
epileptic after gluttonous indulgence in beans. 
Haig’s urine analyses in cases of epilepsy showed a dimin- 
ished excretion of uric acid for several days prior to an attack 
and a greatly increased excretion during and following an attack. 
Here we have a picture of a storing up of uric acid before an 
attack and its circulation in the blood during the pathological 
display we call epilepsy. 
Bearing in mind Haig’s observations upon uric acid and 
increased arterial tension, is it not natural that Broadbent and 
others should write of the merits of a farinaceous diet, and the 
former should even have differentiated so closely between his 
cases as to find most marked benefit in those showing the 
greatest increase in arterial tension ? 
A further fact which argues the functional nature of epilepsy 
is the complete absence of any pathological lesions in a large 
percentage of cases that have come to an autopsy, and such 
changes as have been found may fairly be considered as 
secondary trophic changes from primary disturbance in the 
vascular system. 
In this disease Bartholow tells us that “there is nothing of 
a pathological nature noticed about the patient during the moment 
of absence of ideation but a pallor of the face and dilatation of 
the pupil.’' 
ABSENCE EPILEPSY. 
ECSTATIC EPILEPSY. 
In this disease the same author teaches that there is a death- 
like pallor of the face and a small pulse. 
These symptoms seem to place beyond doubt the involve- 
ment of the sympathetic in epilepsy, and the use of A1 kalithia 14 
ALKAEITHIA IN EITH/TM1A. 
which will remove the cause of irritation to the sympathetic in 
cases marked by lithaemia, is scientific treatment, for it is the 
ideal treatment for lithaemia. 
ANGINA PECTORIS. 
Two classes of opinions are held to by medical writers as to 
the precise nature of angina; one being that it is a purely func- 
tional disease, the other that every case is the expression of 
structural change in the heart. Douglas Powell, of London, 
considers all cases of angina of vaso-motor origin, and believes 
that the heart may succumb to an anginal attack without leaving 
any trace of structural change. In angina gravior, where changes 
are found in the coronary arteries and other parts of the heart, 
they are interpreted as no essential part of the angina. 
Bartholow believes there are usually present arteritis and 
calcification of the coronary arteries, but that these changes are 
“purely accidental.” Quain, of London, sees in “the lithic acid 
or gouty diathesis” an efficient cause of angina. 
Irving C. Roose stands squarely upon the theory of vaso- 
motor perversion originating in the lithic acid diathesis. German 
writers are largely unanimous in assigning it to the gouty 
diathesis. The symptomatology of an attack of angina is a clear 
picture of a vaso-motor neurosis, with contraction of the peri- 
pheral capillaries, and I think it may be said that T. Lauder 
Brunton is nearest to the truth when he compares the pain of 
angina pectoris to the pain of overdistention of the bladder in 
urinary retention. I cannot better express his idea than by using 
his own language: “Angina pectoris might be said to be due 
neither to high tension alone, nor to weak heart alone, but to 
weakness of the heart in relation to the resistance it had to over- 
come, and it might be brought on by weakening the heart, or by 
increasing the resistance, or both.” He recognizes the necessity 
of a restricted diet in gouty cases and an elimination of the pro- 
ducts of waste to effect a cure. 
Placing the aetiology of angina in vaso-motor spasm, we see 
how fully Lauder Brunton’s theory of the mechanism of an at- 
tack of angina explains all the symptoms. The opposing force 
of arterial spasm impedes the peripheral circulation, driving back 
upon the heart a volume of blood that temporarily overpowers it 
and fills its cavities to overdistension. Most intense strain is put ALKALITHIA IN LITH/EMIA. 
15 
upon every part, and as Quain has shown, rupture of its walls 
sometimes occurs, and as Brunton has shown, overdistension »s 
synonymous with pain. 
The unusual intracardiac pressure would cause endocaritis, 
and in the coronary arteries endoarteritis and secondary cal- 
careous degeneration found in so many cases, which are the 
effects of angina, not the cause. 
The author has had one case which clearly demonstrated 
that may originate angina. A little girl of ten years, 
born of a rheumatic father, with a personal history of chronic 
tonsilitis, cystitis, rheumatism and a fluctuating urine, was seized 
with angina pectoris. Glonoin, which is known to relax the cir 
cular fibres of blood vessels, gave speedy relief. Inquiry elicited 
the fact that for two days prior to the attack the urine had been 
“as clear as well water,” and an examination of some of it gave 
a sp. gr. of 1.002, showing almost no elimination of solid matter. 
This patient was put upon Alkalithia to restore renal elimination. 
It was continued at intervals for a rew weeks with the result of 
curing her of tonsilitis, cystitis, rheumatism and angina, and 
giving her a better condition of health than she had had for 
years. 
Look for a litluemic cause in the next case of angina, and 
try Alkalithia. 
DERMATITES. 
That should originate this class of cases is most 
natural, if we stop to think how vaso-motor innervation has to 
do with nutrition. 
Our best dermatologists now speak of the dermatites as 
neuroses. 
All such cases of skin disease as are marked by a dry, 
wrinkled, shrunken, parchment-like condition of the skin, ac- 
companied by exfoliation, whether merely furfuraceous or in 
large pearly scales ; the hair being dry, uneven, thin and shed- 
ding ; the nails dry, horny, thick and brittle—cases showing 
poor nutrition—should be viewed in the light of nutritive changes 
due to a primary disturbance in vaso-motor innervation. 
Alkalithia is a sovereign remedy in the treatment of such 
cases, and 1 recall one case in particular of psoriasis that was 
rapidly cured by Alkalithia which had received but little benefit 
at the hands of several physicians including the writer, until my 16 
ALKALITHIA IN LITH/EMIA. 
attention was drawn to the defective renal elimination which 
pointed to the aetiology of the case. 
Bear in mind that the dermatites may be neuroses of lithaemic 
origin, and that Alkalithia will remove the cause. 
In conclusion I wish to call attention to the practical clinical 
virtues of the combination of the alkalies with caffeine called 
“Alkalithia” in comparison with any and all other alkalies. 
Having decided that you have a case of lithasmia and wish 
to use the alkaline treatment, your choice should be Alkalithia 
for the following reasons: (i) Being made by Keasbey & Mattison 
Company you are guaranteed a perfectly pure and carefully pre- 
pared product. (2) Being effervescent it is pleasant to take and 
the carbonic acid gas liberated during effervescence causes it to 
agree with even the most sensitive stomach that would rebel 
against any and all other alkalies. (3) If the alkaline treatment is 
indicated we believe that the sooner the system is saturated with 
an alkali the better, and we know of no method by which twenty- 
five-grain doses of an alkali, as contained in a dose of Alkalithia, 
can be taken with such freedom from unpleasant after-effects as 
by the use of Alkalithia. (4) The use of Alkalithia insures the 
patient getting a liberal amount of water, which is necessary if 
you would have free urination ; without which you can not flush 
the solids out of the system even should you neutralize them by 
the liberal use of alkalies in more concentrated form. (5) By 
combining the alkalies in Alkalithia with caffeine we augment 
the bulk of the urine at the same time we neutralize its solids 
and thereby flush the kidneys and wash the solids out of the 
system, caffeine being the ideal diuretic that dilates the renal 
capillaries at the same time that it strengthens the heart and 
increases the blood pressure. 
LITH/EMIA 
AS AN FACTOR IN DISEASE, 
AND THE USE OF 
ALKALITHIA 
IN THE TREATMENT OF THE SAME.