24 



METABOLISM IN SEVERE DIABETES. 



CASE K. 

 DESCRIPTION OF THE CASE. 



Male; born June 1863; widower; undertaker; onset of diabetes, November 

 1907; came under our observation August 19, 1908; died in coma November 4, 

 1910. The early history of the case has previously been published. 1 



On February 24, 1910, the patient reported himself as feeling very well. 

 The quantity of urine was said to be 2000 c.c. 



On March 26, 1910, he said that his face felt alternately flushed or numb, 

 and he suffered from both polyphagia and polydipsia. Although on the day 

 previous he had had diarrhea, he was constipated on this day. He was just 

 recovering from an attack of the grippe, from which he had been suffering six 

 weeks. A physical examination on this date gave the following results : Lungs 

 normal; heart, both first and second sounds at the left border of the sternum 

 prolonged; blood-pressure, 115; pulse-rate, 84. 



In July 1910, he again entered the hospital. There appeared to be no 

 particular change in his condition, except a loss in weight. His diet had been 

 lax, and he said that he felt better than when on a strict diet. On November 4, 

 1910, the patient died, having been in coma for about 28 hours. Except for 

 complaints of headache during the previous week, no especial change had been 

 noted in his condition. 



The data regarding the urine from March 22 to August 24, 1910, inclusive, 

 are given in table 13. At the times of these observations the urine gave an 

 acid reaction. Very slight traces of albumen were found from July 24 to 28, 



but none later. 



Table 13. Clinical chart Case K. 



'For 19 hrs., from 12 noon July 25 to 7 a.m. July 26. 2 By fermentation method, 178 gms. 



EXPERIMENTS WITH CASE K. 



One calorimeter experiment and one respiration experiment with this sub- 

 ject were reported in the previous publication. These were both fasting exper- 

 iments, the chair calorimeter being used in the calorimeter experiment. In 

 this publication three respiration experiments are reported. The vital statis- 

 tics are as follows: 



Date of birth, June 1863; height, 180 cm.; body-weight without clothing 

 during experiments, 55.6 kilos. 



Benedict and Joslin, loc. cit., p. 139. 



