492 PRACTICE OF PHYSIC, 



to a considerable degree, and subsists long without being accom- 

 panied with evident disorder in any particular part of the system. 

 The great thirst which always, and the voracious appetite which 

 frequently occurs in it, are often the only remarkable symp- 

 toms. Under the continuance of the disease, the body is often 

 greatly emaciated ; and a great weakness also prevails. The 

 pulse is commonly frequent ; and an obscure fever is for the 

 most part present. When the disease proves fatal, it generally 

 ends with a fever, in many circumstances, particularly those of 

 emaciation and debility, resembling a hectic. 



" I have found the cases of diabetes, with which I have met, 

 to be attended with an unusual dry ness of the skin : in one case 

 it was not only dry and cold, but manifestly shrunk and shri- 

 velled ; and I found, that by warm bathing I could restore it 

 to its usual moisture and softness, and that by friction the heat 

 of the skin could be restored ; and as this circumstance took 

 place, the urine was diminished in proportion. Another patient 

 I made go to a warmer climate. He had come from the dry 

 rock of Gibraltar, in consequence of which he was seized with 

 the diabetes ; I advised him to return, he followed my advice, 

 was cured of the disease, and has continued perfectly well ever 

 since, making his return to a colder country gradually." 



MDX. The proximate cause of this disease is not certainly 

 or clearly known. It seems to have been sometimes connected 

 with calculous affections of the kidneys ; and it is possible, that 

 an irritation applied there may increase the secretion of urine. 

 It perhaps often does so ; but how it should produce the sin- 

 gular change that takes place in the state of the urine, is not to 

 be easily explained. It certainly often happens, that calculous 

 matters are long present in the urinary passages, without hav- 

 ing any such effect as that of producing diabetes in any shape. 



Some have supposed, that the disease occurs from a relaxed 

 state of the secretory vessels of the kidneys ; and indeed, the 

 dissections of persons who had died of this disease, have shown 

 the kidneys in a very flaccid state. This, however, is probably 

 to be considered as rather the effect than the cause of the 

 disease. 



That no topical affection of the kidneys has a share in pro- 

 ducing this disease, and that a fault in the assimilation of the 



