DIABETES MELLITUS. 841 



that patients in comfortable circumstances, and who possess the means 

 of taking good care of themselves, hold out against diabetes much 

 longer than those who are obliged to seek refuge in hospitals. A 

 complete and permanent recovery from diabetes (if it ever occur at all) 

 is extremely rare ; although plenty of cases have been recorded in 

 which a pause in the symptoms, of longer or shorter duration, has 

 been observed. Death, when not the result of some intercurrent com- 

 plication, usually takes place with the signs of extreme marasmus. 

 Sometimes nervous symptoms arise shortly before death, calling to 

 mind the characteristics of uraemic intoxication. 



TREATMENT. Numerous remedies and " cures " have been recom- 

 mended for diabetes ; unfortunately, most of them have been devised 

 upon principles based on purely hypothetical views as to the nature 

 of the disease, and very few of them rest upon facts established by ex- 

 perience. We shall not discuss procedures such as that whose object 

 is to hinder the conversion of amylum into sugar by exhibition of acids ; 

 or that in which nitrogen is to be supplied to the system by adminis- 

 tration of ammonia ; or in which it is sought to allay irritability of the 

 kidneys by means of opium ; or to act upon the liver by means of ox- 

 gall, or gallic acid, or any of the other purely theoretical suggestions. 

 We are indebted to Griesinger for a positive experimental demonstra- 

 tion of the inefficacy, and in some cases even the detrimental character, 

 of some of these modes of treatment, such as that by alcohol, rennet, 

 yeast, sugar intended to supply the place of that lost from the blood. 



Experience has also established the fact of the beneficial influence 

 of certain dietetic rules, the first hints of which, however, were derived 

 from theoretical reasoning. It is of the utmost importance that dia- 

 betic patients should live principally upon animal food, and that they 

 should eat but very little starchy or saccharine matter. The absolute 

 prohibition of food containing starch and sugar has been abandoned 

 of late ; experience having taught, in the first place, that although the 

 loss of sugar might undergo temporary diminution by this procedure, 

 yet it could not cure the diabetes ; and besides, it has been found that 

 there are very few patients who for years can endure a diet consisting 

 exclusively of meat, eggs, fish, oysters, crabs, salad, and Bouehardatfs 

 bran-bread. It relieves the patients greatly, in carrying out the rest 

 of the treatment, to allow them to eat a small portion of bread daily ; 

 and it does them no material harm. If we do not allow them this in- 

 dulgence, we run the risk of their soon becoming so impatient, at the 

 excessive restraint, as to refuse further obedience, and make up for lost 

 time by eating copiously of bread and fruit, for which they almost 

 always have a great desire. Besides the meats, the patient may be 

 allowed such vegetables as do not contai^ either sugar or starch, or 



