A Case of Magnesium Deficiency 



303 



gluconate was given intravenously but in insufficient amounts, 

 and in retrospect it is clear that she was in negative calcium 

 balance. No thought was given at this time to the possibility 

 or the significance of any magnesium loss. 



In such an ill patient adequate nutrition and the replace- 

 ment of protein is very difficult to achieve and her oral food 

 intake was augmented by intravenous feeding. The fluids 



INTAKE 

 (litres)^ 



URINE 

 OUTPUT 



ILEAL FISTULA — WATER BALANCE 



A.M. 1954 



INTRAVENOUS 

 ORAL 



PlTl 



^^^^^P^^^^^m^^^^^^X^^^TTl^d^kT^^^^ 



I 2 3 4 5 6 7 8 9 10 II 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 

 5- DAY PEROOS 



Fig. 1. Chart showing fluid intake and urinary output over a five-month 

 period, with the appearance of symptoms one month after the onset. 



given were glucose solutions, sodium lactate, and alcohol, 

 while a casein hydrolysate supplied nitrogen. Loss of blood 

 was replaced by blood transfusions. Despite all these measures 

 she undoubtedly lost weight. 



Fig. 1 shows the extent of the fluid replacement necessary 

 over nearly five months, plotted in five-day periods, and it will 

 be seen that the losses were very great. At their maximum, 

 calculation shows that the fistula losses were of the order of 

 five litres a day. Since the patient at this time weighed less 



