il4 DIABETES INSIPIDUS 



In contrast to these cases, there are others in which the amount of nour- 

 ishment consumed is very slight, and in which nevertheless the body-weight 

 is maintained. Quite a number of observations have been recorded which 

 show that adults can maintain their K-equilibrium upon a diet containing 

 remarkably small quantities of albumin (35 grams in a person weighing 55 

 kilograms). 



In most cases, however, the quantity of nutriment is about the normal 

 amount. 



Quite frequently in patients suffering from diabetes insipidus, the tem- 

 perature is found to be conspicuously low. Whether this is simply to be re- 

 garded as the result of a profuse ingestion of cool drink cannot be decided. 

 In view of the diminished metabolism which may be observed in some of the 

 patients, we must consider the possibility that the diminution in the body 

 warmth is to be referred to a lessened oxidation, such as occurs in old 

 people. 



In contrast with this, an enormously increased body-weight has been re- 

 ported in isolated cases. 



Disturbances on the part of the organs of circulation, such as cardiac 

 hypertrophy, apparently do not occur; on the other hand, the digestive appa- 

 ratus is sometimes damaged by the profuse ingestion of fluids. Gastric 

 catarrh, especially, develops not infrequently; true gastrectasis is only noted 

 exceptionally. 



The psychic functions do not appear to suffer serious disturbance, although 

 hypochondriacal and melancholic attacks are frequently met with. In the 

 cases which run their course with decided implication of the somatic condi- 

 tion, these psychic disturbances are the rule. Occasionally, in diabetes in- 

 sipidus occurring in youth, a general retardation of mental development is 

 observed. 



Of other nervous disturbances, only sciatica is to be mentioned as a com- 

 paratively frequent complication of diabetes insipidus. 



In the main, the diabetic does not appear more predisposed to general or 

 organic disease than are healthy individuals. The reports that he is particu- 

 larly susceptible to all sorts of infectious diseases, and that he is very liable 

 to be attacked by tuberculosis, have not been confirmed by the study of more 

 complete statistics. 



Only with one disease is there a close connection which must be somewhat 

 more minutely considered; I mean diabetes mellitus. This may be in vari- 

 ous ways. 



The connection is clearest in the cases of diabetes due to disease of the 

 Irain. A number of cases are on record in which, after trauma to the head, 

 true diabetes mellitus with an increased urinary flow first appeared, the sugar, 

 however, disappearing after a few weeks, and then for a long period, some- 

 times for years, a simple polyuria persisted. We know from Claude Bernard's 

 experiments that the region, injury to which gives rise to polyuria, is situated 

 only a few millimeters above the glycogenic area ; later investigations by Eck- 

 hard have shown that in rabbits by lesions in the region of the sinus rhom- 

 boidalis, sometimes glycosuria, sometimes polyuria, may be produced. It is 



