296 THE SECRETIONS: 



I have recently had an opportunity of making a careful ex- 

 amination of the excretions of a diabetic patient. He was a man 

 aged 40 years, who had suffered from intense thirst and had 

 observed a great increase in the amount of his urine for the pre- 

 ceding ten months. At the period of his admission into the 

 hospital, the colour of his urine was normal, and an acid reac- 

 tion always observed, which, however, became more decided 

 some time after emission : in the course of ten or twelve hours 

 it usually became turbid, and deposited a light viscid sediment 

 consisting of amorphous urate of ammonia and mucus-corpuscles; 

 on two occasions (during the use of a very animal diet) crystals 

 of uric acid were noticed in the sediment. During the period 

 of my investigations I never detected albumen in the urine. 

 The specific gravity varied from 1039 to 1030. It was highest 

 at the commencement of the treatment. 



On admission the daily amount of urine averaged nearly five 

 quarts, but while under treatment it was reduced to three quarts. 

 The daily amount of sugar gradually diminished to one third, 

 but was never so thoroughly reduced as to afford hopes of a 

 permanent cure. The daily excretion of urea was at first much 

 diminished, but subsequently reached the healthy average. 

 Uric acid was always present, but not in so considerable a quan- 

 tity as would have been found in the urine of healthy persons 

 living on a similar diet. The amount of fixed salts varied con- 

 siderably, but was always larger than in a state of health. 



After the use of the ordinary hospital diet for a few days, he 

 was placed on a very nitrogenous diet, consisting of beef-tea, eggs, 

 meat, milk, and white bread. Subsequently coffee was substituted 

 for the milk, and the amount of bread diminished. And still later 

 gluten-bread containing only one-half the amount of starch, but 

 three times the amount of nitrogenous matter, was given in its 

 place. 



During his last three weeks he consumed daily, one pound 

 of gluten-bread, two of beef from which a quart of beef-tea 

 had been made, besides a quarter of a pound of ordinary boiled 

 beef, three or four ounces of roast veal, six eggs, and two quarts 

 of coffee prepared from an ounce of the beans. Although this 

 quantity was (according to his own statement) sufficient to 

 satisfy his hunger, he was occasionally detected in appropriating 

 the farinaceous diet of other patients. With regard to medical 

 treatment, opium and its various compounds were first given ; 



