SYMPTOMS. — TREATMENT. 325 



as the caustic is added, leaving the sohition of a dark-bhie 

 colour. The mixture is now gradually heated to the boiling- 

 point, when, if sugar is present, a yellowish-brown precipitate 

 of the sub-oxide of copper is thrown down ; should no sugar be 

 present, a black precipitate of common oxide of copper is 

 deposited. 



In the fermentation test a little fresh or dried German yeast 

 is added to a small quantity of the urine ; a test-tube, iilled 

 with the urine thus treated, is carefully inverted in a saucer 

 containing the remainder, and allowed to remain at rest in this 

 position for some hours, the temperature of the place being 

 maintained about 80° F. If sugar is present the vinous fer- 

 mentation is speedily developed, during which carbonic acid is 

 evolved, indicated by gentle effervescence, and the presence of 

 the gas at the upper part of the inverted tube ; if no sugar is 

 present there will be no effervescence, nor the presence of any 

 gas. One cubic inch of gas so formed will represent one grain 

 of sugar in the urine. 



It is upon the existence of sugar or saccharine material in 

 the urine that the diagnosis of mellituria must depend. It is 

 also to be borne in mind that the quantity of sugar present in 

 undoubted cases of diabetes mellitus varies, it being perfectly 

 possible that at some periods of examination none may be 

 found. 



Treatment. — In the treatment of diabetes mellitus the ulti- 

 mate results are as unsatisfactory as the different theories re- 

 specting the rationale of the morbid process are conflicting ; 

 the most which as yet it has been possible to attain being 

 palliation of the more distressing symptoms. Many methods 

 of treatment have been adopted, and nearly every agent in the 

 Pharmacopa?ia likely to operate in arresting the great waste of 

 tissue and peculiar sugar-formative process has been experi- 

 mented with. Some of these have, for a time, given hopes of 

 ultimate success. There has been improvement in the general 

 symptoms, with a diminished quantity of sugar in the urine ; 

 ultimately all has become changed, the disease asserting its 

 supremacy with increased vigour, or becoming complicated 

 with other morbid phenomena, most probably with fatal changes 

 of a tubercular character in the lungs. 



A carefully selected and strictly enforced dietary, in which 



