DIABETES. 223 



It should be given in two or three-drop doses in a tea-spoonful of water every two 



l;ro:;:i de of i) >tassium has l>een used with success in some cases. 



Nitrate of uranium has sometimes proved efficacious. It not only quickly 

 reduces the quantity of urine, Imt restores the strength and improves the general 

 condition : the dose is one-sixth of a grain in water three times a day, or a smaller 

 [uently. 



The liquid extract of ergot, given in thirty-drop doses in water three times a day, 

 lias proved of such signal benefit in diabetes insipidus that where other remedies 

 tailed we should advise a trial of it in saccharine diabetes. In one case in 

 which we gave it, it undoubtedly did ijood. 



There is one social form of treatment to which some reference must be made. 

 It is known as the " skim milk " treatment. Several cases are reported in which 

 the quantity of urine was steadily and greatly diminished and the specific gravity 

 poiidiiiLrly reduced, by restricting the patient to a daily allowance of six pints of 

 skimmed milk. It has the great advantage that it can be adopted without in any 

 way interfering with the patient's ordinary occupation. The skim milk is the only 

 food allowed ; and nothing else of any kind is to be taken. The quantity of milk 

 should be fixed, and it should be taken at definite times, so as to constitute meals. 

 : 1 probably have to be continued for six weeks, and then any kind of animal 

 food may be allowed once or twice daily; bran bread, gluten bread, <fcc., .being 

 gradually added to the dietary. 



This, then, completes our account of diabetes mellitus, and we must now consider 

 the other form of diabetes. 



Diabetes Insipidus. In this complaint, as we have already seen, the patient 

 passes very large quantities of water, but it is free from sugar or other abnormal 

 ingredient, 



The quantity of urine secreted by persons affected with insipid diabetes is usually 

 greater even than in saccharine diabetes ; and it is not uncommon for fifteen, thirty, 

 or even forty pints, to be passed in the twenty-four hours. We at one time had tinder 

 our care a man who habitually passed twenty-two pints of water in the course of the 

 day and night. He was kept under constant supervision, and the urine was care- 

 fully measured, so that there was no mistake about it. He usually had to pass his 

 urine two or three times in an hour, and was on this account unable to go to church 

 or to any place of amusement. He usually had a slop pail tinder his bed in addition 

 to two ordinary chamber-utensils. In the case of another patient, it was stated 

 that the ordinary chamber-utensil was "not a bit of good to her," and she was 

 always obliged to have a big pail in her room. The urine is generally of a light 

 straw colour, clear and free from deposit. Its specific gravity is always very low, 

 and in this respect it presents a marked contrast to the urine passed in diabetes 

 mellitus. Sometimes, in fact, it is very little heavier than water, so that the 

 urinometer may stand at 1,001 or 1,002. This thin, limpid urine decomposes very 

 rapidly, and usually becomes extremely offensive after standing for even a very 

 short time. 



The intense thirst experienced in these cases is one of the most distressing 



