ADDITIONS TO THE REVISED EDITION OF 1880. 847 



of some intercurrent disease, the daily flow of urine becomes normal, 

 and returns to its former profusion after the attack has terminated. As 

 a rule, the malady lasts for years without imperilling life. It is only 

 in rare instances, as in that of Neuffer^ already alluded to, that death 

 takes place without the intervention of some other disease. Complete 

 and permanent recovery from diabetes insipidus is likewise an ex- 

 tremely rare event. 



TREATMENT. It is always suspicious when numerous remedies are 

 recommended for a disease ; in such cases, usually, none of them have 

 any special effect on the course and termination of the affection. This 

 is also true of the recommendations of saltpetre, in the shape of sal 

 prunellse, of valerian, belladonna, opium, ergotine, creosote, and 

 other remedies in diabetes insipidus. They are not based on the 

 results of experience, but on theoretical grounds. I have not used 

 any of these remedies persistently and energetically, as my patients 

 bore their disease pretty well so that there was no necessity for 

 energetic treatment. On the whole, I would advise you, in treating 

 simple diabetes, to limit yourselves to preventing the bad results 

 induced by the disease, or to combating them if they have already 

 appeared. Especial attention should be paid to the disturbances of 

 digestion and nutrition, which are not uncommon. Rational diet, 

 combined with cod-liver oil, malt extract, and iron, improved the con- 

 dition of the little girl above-mehtioned, without diminishing her thirst, 

 or the secretion of urine ; and, although her early death had been 

 expected, she was discharged from the clinic considerably increased in 

 weight and much improved in health. 



ADDITIONS TO THE REVISED EDITION OF 1880. 



SECTION III. GENERAL DISORDERS OF NUTRITION. 



1. P. 803. 



According to Virchow, in obstinate cases of chlorosis there is 

 defective development and small size of the aorta and vessels gen- 

 erally. The aorta may be so small as not to admit the little finger, 

 while its walls may be uncommonly thin ; they, however, retain 

 their elasticity, unless there has been fatty degeneration of the 

 inner and middle coats. This failure of vascular development is 

 sometimes accompanied by stunted growth of the whole body. 

 The heart is sometimes small, but is usually normal, or slightly di- 

 lated ; exceptionally it is hypertrophied. There is an inclination 



