URINE. 303 



off. Willis 1 relates a case of diabetes that fell under his own 

 observation, in which the furfuraceous exfoliation of the cuticle 

 had a decidedly sweet taste. 



From pathological anatomy we learn that the kidneys in 

 death from diabetes are very frequently softened, and according 

 to Meyer (who refers the formation of sugar to the kidneys), 

 even disorganized, their blood-vessels much enlarged, and the 

 substance of the papilla? and the tubuli very permeable ; the 

 kidneys have also been found inflamed, atrophied, suppurating, 

 and containing calculi. The condition in which the liver has 

 been found is also various : the bile is, however, usually very far 

 from being in a normal condition ; it is of a pale yellow colour, 

 very fluid, and, instead of being alkaline, has usually an acid 

 reaction. The veins which form the portal system are over- 

 loaded, and the mesenteric vessels are generally congested. 

 As the disease becomes further developed the lungs participate 

 in the general disturbance, for, according to Willis, pulmonary 

 phthisis is the immediate cause of death in two thirds of the 

 cases of diabetes. Traces of morbid action have also been found 

 in the nervous system. 



It is of great importance in reference to the aetiology of dia- 

 betes mellitus to ascertain whether the changes which are 

 revealed to us by the prosecution of the morbid anatomy of the 

 disease, are consequences of the disease itself, or whether they 

 had a previous existence in those blood-metamorphosing organs, 

 the kidneys, liver, and lungs, and whether the formation of the 

 sugar is due to them. 



The questions which I have already suggested are of much 

 importance in elucidating these points. 



Taking into consideration all that is known of the origin of 

 diabetes mellitus, it appears very probable that the sugar is 

 formed not in any single organ, but that it is produced by a 

 diseased condition of the whole system, and we are almost led 

 to adopt the opinion expressed by P. Frank, that a specific in- 

 fluence is exercised upon the nerves of the fauces 4)y a sponta- 

 neously-generated virus diabeticum, which occasions an insatiable 



1 Urinary Diseases and their Treatment, p. 205. 



