AND DIABETES 175 



starch as the oatmeal contains should not make the 

 glycosuria worse, but apparently it does not do so. 

 A diet restricted to potatoes may have the same 

 beneficial effect. 



At the same time, alkahes should of course be 

 administered, either by mouth, rectum, or intra- 

 venously. 



It may be asked. Of what avail is it to give carbo- 

 hydrates, when the tissues will not be able to make 

 use of them owing to the absence of the internal 

 secretion of the pancreas ? If the internal secretion 

 were actually absent, the case would of course be 

 beyond treatment, but there is always hope that a 

 little may still be available to assist in the assimilation 

 of glucose by the protoplasm ; and if the sugar has 

 been expelled from the blood by severe dieting, so 

 that acidosis has resulted, the administration of 

 carbohydrate may save the situation. 



Again, it may be asked, Why not give extract of 

 pancreas as a drug ? Unfortunately, it has been 

 thoroughly tried and has failed. Most probably the 

 active principle is either destroyed by digestion or 

 is not absorbed from the bowel. Pancreatic grafting 

 gives some temporary relief in animals. 



It is well known that diabetic coma may be pre- 

 cipitated by a surgical operation. In some cases 

 matters are so urgent that there is no time for 

 precautions to be taken to avoid this calamity, but 

 if a day or two can be secured first, it should be 

 possible with our present knowledge to banish this 

 bugbear from surgery. It will be much safer to give 

 ether than chloroform, on account of the danger of 



