PART I. 



INTRODUCTION. 



It is acknowledged by all clinicians that the most satisfactory treatment 

 of diabetes mellitus is obtained by a careful and intelligent regulation of the 

 diet. The use of drugs has invariably met with but transitory success ; modern 

 clinicians are therefore relying less and less upon such remedies and are turning 

 their attention more definitely toward a careful dietetic regime. Accordingly 

 it is of fundamental importance that all the knowledge possible should be care- 

 fully accumulated regarding the uses made by the diabetic patient of the diet, 

 the demands of the body for nutriment, and the best kinds of food to be 

 ingested. It is of further importance that the reaction of the healthy indi- 

 vidual to the narrow diet of the diabetic should be investigated, and this espe- 

 cially because the studies upon acidosis have shown that the metabolism of 

 health may be made to closely approximate that of disease by simple external 

 influences, such as the withdrawal of all carbohydrate and the excessive admin- 

 istration of fat. 



In our earlier investigation 1 we endeavored to study the energy transfor- 

 mations of diabetics without giving particular attention to the influence of the 

 intake of food. It was believed that the energy transformations without food 

 should first be clearly established, and then a study should be made of the influ- 

 ence of various foods upon the metabolism of diabetics, with particular refer- 

 ence to the effect of the so-called "oatmeal cure," which has received much 

 attention in recent years. 



Although the method of study has not been materially modified in our 

 later observations now to be recorded, our experience in the first series has 

 enabled us to plan to better advantage each individual experiment with the 

 purpose of making it an improvement upon those preceding. Careful atten- 

 tion to experimental details, a most scrupulous regulation of the diet, and the 

 technical experience acquired in the last three years in numerous experiments 

 of this type with both normal and pathological individuals have all helped to 

 raise somewhat the standard of accuracy and give us increased confidence in 

 the correctness of the plan of procedure. In the earlier investigation as many 

 individuals as possible were studied in order to determine their general energy 

 requirement for comparison with the energy requirement of normal individuals; 

 in the later series of observations the attempt was made to study systemati- 

 cally and completely the individual subjects rather than to make a large number 

 of less detailed observations on a variety of subjects. At least three of the 

 cases reported herewith have been most carefully studied over a considerable 

 period of time. 



Benedict and Joslin, Metabolism in Diabetes Mellitus, Carnegie Institution of Wash- 

 ington Publication No. 136, 1910. 



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