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John E. Berwind Free Maternity Clinic
Dr. I. L. Hill, Director
124 East 103d Street, New York City
Agar. Agar jellies, washed bran cookies, broth and thrice boiled
vegetables have been used rather extensively to appease hunger,
tho they have been curtailed as much as possible to avoid
too great distention of the abdomen.
The urine contained a trace of acetone ([?]
reaction) constantly for the first year of treatment, but
during the last 6 months here has bee none, altho
the Fat/glucose ratio has for some time been 2:1
For a time, NaHCO3 was given in small doses, not
to combat the trivial acidosis, but to allow water
retention and so prevent too great loss of weight.
Recently, no soda has been used, but the patient is allowed
generous rations of table salt, with the same end in view.
He is now, as you will judge from the weight (26#)
very considerably emaciated. He walks about the house
tho to look at his legs one would suppose him unable
even to stand. He can be interested in numerous diversions
but for months has not had the energy to play by himself.
Occasionally, he is very irritable, and rarely - almost unmanageable.
It looks to me as tho a very few more months on
this starvation diet will be all he can hold out - and we
are very sure that any increase of diet would shorten his
existence.
I need not tell you how earnestly I hope that you
will see your way clear to treat him. We will
try to pay whatever fee you consider due yourself -
it would be very unfair for you to change only the
expense of preparation of the extract, as you spoke of
doing.
Hoping for an early consideration of the case, I am
Your sincerely,
Morton Ryder
The address on the letterhead will reach me until July 1.
After that, I will be at Carmel, New York
M.R.