280 KOLLIN T. WOODYATT 



in respect of its ability to form acetoacetic acid to 0.16 gram molecule of 

 higher fatty acid. If the acid were oleic (molecular weight 284) this 

 would represent 45.44 grams. This affords a tentative figure that serves a 

 practical purpose even though it be subject to correction. 



The relationship may be expressed in the form of an equation. If 

 F A is the total quantity of higher fatty acid introduced into the metabo- 

 lism (plus ketogenic amino-acids expressed in terms of higher fatty acid) 

 and if P = protein; and F = fat (neutral), then 



(1) F A = .44 P -f .9F 



We have previously noted that the total glucose derivable from a given 

 food supply may be expressed approximately as 



(2) G = C + .58P + .1F. 



If the ratio of F A : G, which, if exceeded, leads to acetonuria, is in a 



F A 



given case 1.5 : 1, then when - _, = 1.5 we derive from (1) and (2) the 



equation F == 2 C -j- .57 P, which for clinical purposes and convenience in 

 mental calculations may be stated simply as 



(3) F = 2C+- 



Dietetic Management of Diabetes 



In the dietetic management of diabetes we are engaged in the effort 

 to correlate symptoms and signs shown by the patient with the kinds and 

 quantities of food that he consumes. The success of treatment, the aver- 

 age of results in all types of cases, depends on the truth of one's concept 

 of the relationships between symptoms or signs and the food supply. Dur- 

 ing the last few years the average of results obtained in the diabetic man- 

 agement of diabetes has been much improved through the work of Allen 

 and Joslin and the system that they have developed is in some respects 

 more logical and less empirical than any that we have had heretofore. 

 Yet the literature of the subject is still confused by a lack of unanimity 

 among all writers as to the best manned of handling all cases. In a recent 

 monograph, Falta(e) has again told the merits of his "cereal cure" (Mehl- 

 frilchte Kur), and endorsed methods of management that differ materially 

 from that which has found so much favor in this country. Newburgh 

 and Marsh, of Ann Arbor, failing to achieve practical results by their 

 application of the principles of "total dietary restriction" resort to low 

 protein, high fat diets with striking immediate results in the manage- 

 ment of seventy-four cases. In the past, good results were obtained in 

 some cases by old fashioned "rigid" diets. The remarkable improve- 

 ments that have sometimes been seen with the institution of a Donkin 



