Dr. Alvarez Says--

              Sunday, Jan. 19, 1969 THE SHREVEPORT TIMES
Dr. Alvarez Says—
By DR. WALTER C. ALVAREZ
For 25 Years a Mayo Clinic Consultant
In a recent article in that fine journal, "Post-graduate
Medicine," Dr. M. D. Hargrnvp .Tr wrote of
the distress in the gullet that occasionally is associated
with a slightly larger-than-normal hole in the midriff.
The hiatus is a hole through which the gullet goes on
its way down to the stomach.
Many years ago my old friend,
that very able surgeon Dr.
Harrington — at operations —
measured the size of this hole or
hiatus in hundreds of patients,
and found it bigger than neces-sary
in some 2 out of 3 cases.
For many years we physicians
knew' about hiatus hernias 'her-nia
means rupture and a rupture
usually means the passage of a
bit of stomach or bowel through
a hole in the abdominal wall—a
hole that is bigger than normal).
But for years the only Mayo
surgeon who so far as I knew
operated on some of these hiatus
hernias—through which some-times
a little bit of the stomach
slid up into the chest—was Dr.
Harrington; and after a while he
quit.
Even when I was seeing
hundreds of patients, I rarely
saw one who, I thought, needed
an operation to make the hiatus
smaller. Usually I was pretty
sure that the symptoms were not
due to the hernia; and for years
most surgeons felt as I did.
As Dr. Hargrove says in his
article, in 1961, Drs. J. S. Rex, H
A. Anderson, L. G. Bartholomew,
and J. C. Cain of the Mayo
Clinic, reported a 10-year study
of patients they had seen with
hiatus hernias, and symptoms of
irritation of the gullet—-due prob-ably
to an excessive amount of
regurgitation of irritating gastric
contents back up into the gullet.
They gave drugs to neutralize
the stomach acid in the gullet
and their results were good in by
far most cases.
For a few years, in some
places it was the custom to
operate for many hiatus hernias,
but then, I think, most surgeons
went back to operating only
when the symptoms were severe
and were almost certainly due to
the hernia. Many patients have
had a little pain and a little
tendency to belch only when, like;
me, after a big meal they bend
over to remove their shoes.
Naturally, I did not want to be
operated on just to relieve
that!
Sel . ed
With medical treatment, as
by washing the acid down the
gullet with perhaps a little
baking soda in a glass of water,
patients with a sore gullet can
often get relief. Accordingly, the
Mayo group of Dr. Rex and
others seldom have had these
patients operated on. Some peo-ple
with obvious regurgitation of
food back even into the throat,
can avoid the distress by not
going to bed and lying flat until
their stomachs are empty.
A few persons got into trouble
with hiatus hernias because they
got so much fat in their
a b d o m i n a l cavity—fat that
pushed their stomachs up into
the hiatus. I remember well a fat
woman who traveled many thou-sands
of miles to the Mayo Clinic
with severe symptoms due to a
hiatus hernia. Our surgeons said
they would not operate until she
took off at least 50 pounds. So
she went to our diet kitchen, and
by the time she had lost 40
pounds, she was so perfectly
comfortable that she went back
home happy.
As everyone knows, this winter
the influenza is attacking so
many people that some schools
are being closed. Fortunately,
this "Hong Kong" flu is not as
severe as was the terrible
influenza of 1918. That killed
millions of even strong young
people. As I said here recently, I
read that in Hong Kong, although
some half a million people were
thought to have had the flu, only
a very few died of it. Health
authorities keep telling us that
the people who are most in
danger of death are the aged and
the weak and sickly.
Commonly the person is in bed
for a few days with a fever of
perhaps 102 degrees and various
other symptoms, such as chills.
chest pains and sometimes a
cough. Then he or she may be
tired for several more days.
Not Always Helpful
People ask, "How can I avoid
the flu?" So far as I can learn,
the vaccine does not always
protect, because there are so
many viruses that can produce
what looks like flu, and so far,
our experts have been unable to
make a vaccine that in one dose
will protect against many vi-ruses.
One difficulty with this
epidemic has been that experts
have not all agreed as to the
cause of the Hong Kong influenza
—whether it is a form of A2
virus of if it is a new A3 virus.
It is a good idea for people to
avoid crowds, as in a theater or
movie house or concert hall. 1
hate to get into a closed taxi in
which all of the air has gone
many times through the lungs of
the driver, and perhaps his last
one or two customers. Because I
so fear such air, always when I
get into a taxi I open somewhat
the window next to me.
Sometimes the taxi-man says,
"Don't do that, I have a terrible
cold." One of the worst colds I
ever had I got by going on with
such a driver coughing and
sneezing in a closed cab on a
cold winter day. Often it is
dangerous to travel, and thus to
come in contact with new viruses
to which one is not immune. Not
all of the influenzas today are
the Hong Kong flu.
Exposure to cold air is not the
cause of a cold or flu; they are
due to some one of perhaps 100
viruses. Polar explorers do not.
get colds or flu until they meet
some men coming from the
"outside" with new viruses.
It is doubtful whether anyone
had heard of hiatus hernia before
1912. Since then, however, it has
become well known. Just what is
a hernia and how can it be
treated? Dr. Alvarez answers
these questions in his booklet,
"Hiatus Hernia." For your copy
send 25 cents and a stamped,
self-addressed e n v e l o p e with
your request to Dr. Walter C.
Alvarez, Dept. ST, Box 957, Des
Monines, low, 50304.