DIET FOB DIABETES. 321 



As soon as the actual existence of the disorder is known, an 

 exclusive regimen of skim-milk is prescribed. And it must be ex- 

 clusive so long as any traces of sugar are found in the urine. All 

 cream must be very carefully removed. Beginning with four to 

 six pints on the first day, the quantity must be increased gradually 

 to from eight to twelve pints daily, according to the age, sex, size 

 and condition of the patient. In.no instance should twelve pints be 

 exceeded ; and if more than seven or eight be given, the remainder 

 should be taken at separate meals in the form of curd produced by 

 essence of rennet. The skim-milk may be taken cold, or at about 

 100, but it must not be boiled. The daily allowance must be 

 divided into regular meals. The curative power of this skim-milk 

 diet is altogether lost if anything be added to it. The abstinence 

 thus imposed is unquestionably very trying to the patient, but it is 

 the condition on which his life is lengthened. Provided there are 

 no complications, great relief, if not a cure, may be expected from 

 this treatment. As a general rule, it will remove the sugar from 

 the urine and completely remove the disease in from twelve days to 

 five or six weeks, if only the hydrocarbons of the food are changed 

 into sugar and in some cases if the albuminates are also thus con- 

 verted. If this stage is somewhat far advanced and the disease is 

 of long standing and attended with much emaciation, it will be 

 arrested in its course and held in check, though not absolutely 

 cured. It should, however, be remarked, that if, after the expiration 

 of a week there is no reduction of the specific gravity and sugar of 

 the urine, the disease is not amenable to skim-milk or any other 

 kind of treatment. On the other hand, if the symptoms are ameli- 

 orated and the patient gains strength, there is much encouragement 

 to proceed and when the treatment has been successful the skim- 

 milk diet should be rigorously continued from a fortnight to six 

 weeks after the disappearance of sugar from the urine, that convales- 

 cence may be confirmed. 



Great stress must also be laid on the careful selection of ingre- 

 dients in the transitional diet, to be adopted when the exclusiveness 

 of skim-milk diet may be lessened and some approach to ordinary 

 fare may be permitted. Skim-milk and curds must still be staple 

 articles; but, in addition, one or two moderate meals of lightly 

 cooked, lean chop or steak, or of roast-mutton or beef, with green, 

 non-starchy vegetables, are allowed. The vegetables whicli Dr. 

 Donkin thinks may be permitted are spinach, lettuce, mustard and 

 cress, the tops of radishes, greens, turnip-greens, French beans and 

 scarlet runners in a very young condition before seed is formed. 

 These are simply not forbidden as highly pernicious ; whether it is 

 judicious to take them is another matter. Beef-tea and mutton- 

 broth, from which the fat has been removed after cooling, and with- 

 out barley or vegetables, except the green leaves of the leek, may 

 also be taken in moderate quantity once daily. Should the progress 

 be favorable and the urine continue to be free from sugar, the fol- 



