122 DIABETES INSIPIDUS 



ishing the amount of fluid ingested, the polyuria , ceases, and never recurs, 

 as is sometimes the case in the hysterical form of diabetes insipidus, it depends 

 ultimately upon the option of the observer whether the case is classed as one 

 of bad habit, or as diabetes insipidus; for diabetes is so comprehensive an 

 entity that such cases as the above can be included under it. In fact, literature 

 contains quite a numbe^ of such examples. 



TREATMENT 



Treatment may be carried out in various ways. Where possible, we should 

 search for the underlying condition which results in polyuria, and an attempt 

 should be made to remove this. 



In diabetes due to cerebral causes, such treatment is practicable only in 

 isolated instances. Nevertheless, a case is on record in which, during the 

 course of an apparently mild pulmonary tuberculosis, acute polyuria appeared, 

 later ioUowed by pain and stiffness in the cervical vertebrse, then paralysis of 

 both arms and legs; here the diabetes was cured, simultaneously with the 

 paralysis, by treatment with Glisson's suspension. 



Otherwise, among the cerebral cases of diabetes insipidus, apart from the 

 traumatic which not infrequently get well without treatment, only those 

 depending upon cerebral syphilis are to be considered; in these cases and all 

 others complicated by syphilis (whether a definite cerebral lesion exists or 

 not), a cure may be effected by the use of iodin and mercury, as has been 

 previously mentioned. 



Somewhat more uncertain are the cases occurring in the course of hys- 

 teria. The fact that hypnotism sometimes brings about a prompt cure is a 

 proof of the purely functional nature of these cases, and of the possibility of 

 an " etiologic therapy " by purely psychical treatment. Whether or not in 

 every hysterical case, or in every case that is suspected of being hysterical, 

 hypnotism is to be employed, is a question that must be answered according 

 to the confidence of the physician in the harmlessness of this remedial agent. 

 In point of fact, in Germany no reports of cures of this kind have been made. 



On the other hand a number of measures of a more innocent nature 

 directed against the general nervous condition have often been quite success- 

 ful. Among these are, first, general dietetic measures, sufficient exercise in 

 the open air, and proper employment; occasionally, change of climate has 

 been successful; often diabetes has been seen to disappear or become less 

 marked in the course of hydr other apeutic treatment. Eegulated cold ablu- 

 tions,- douches, baths, in the milder cases can be carried out at the patient's 

 own home, in the severe cases in hydropathic institutes ; lukewarm baths appear 

 to have a similar effect. 



Among drugs which seem to be of use in a similar way, antipyrin (3 grams 

 daily) and valerian are the favorites; the latter, given up to 20 grams of 

 the powdered root, is sometimes decidedly beneficial; also potassium Iromid, 

 assafetida, and camphor, employed from the same point of view, have occa- 

 sionally been very useful. 



The remedies just mentioned are, a priori, most useful in the cases in 



