TREATMENT 123 



which diabetes insipidus occurs in hysterical individuals. Eegarding the 

 prompt action of valerian, as well as of quite a number of remedies to be 

 mentioned later on, the success of which is reported in the journals every year, 

 it is unquestioned that diabetes insipidus is very often only a symptom of hys- 

 teria which, like other hysterical symptoms, may disappear after the use of 

 the most varied remedies; as, for instance, after the employment of powders 

 of simple sodium chlorid, provided only that simultaneously the necessary 

 psychic influence is exerted. Many cases, perhaps most of those that come 

 under treatment at all, occur in individuals whose malady cannot positively 

 be included in the category of hysteria, yet is closely related to this group 

 of affections, and these people are known as " nervous persons " in the ordi- 

 nary sense of the term. In them, as well as in frankly hysterical cases, success 

 comparatively often follows the use of the previously mentioned remedies. 



Other drugs have been employed with the hope of influencing the circula- 

 tion in the kidneys; the amount of urine in the main depends upon the height 

 of the blood-pressure in the glomeruli, and the more contracted the small renal 

 arteries are the less is the amount of blood which reaches the glomeruli. As 

 the. principal representative of such artery-constricting remedies, ergotin has 

 frequently been administered in diabetes insipidus, particularly in the last 

 few years, as its action has been much praised. Lead acetate and tannin 

 are less useful. 



Atropin and other belladonna preparations, which are supposed to act more 

 directly upon the secretion of the kidneys, have also an inhibiting secretory 

 influence upon most of the other glands. This influence, unfortunately, is 

 more obvious in the salivary glands than in the kidneys; at least, increased 

 dryness of the mouth and correspondingly great thirst have been observed 

 more often than decrease in the amount of the urine. 



Electricity has been employed for the sake of its (supposedly) direct influ- 

 ence upon the renal function. As irritation of the cervical cord diminishes 

 renal secretion in animal experiments (on account of its powerful contraction 

 of the vasa afferentia) the attempt has been made to diminish the amount of 

 urine in man by galvanization of the cervical cord. More recently we have 

 attempted to make the current act directly upon the kidneys (both electrodes 

 in the renal region). Whether the electrical current thus applied has any 

 real action is very difficult to decide ; it is, however, a fact that this treatment 

 is often quite successful. 



Another method by which we have tried to diminish renal secretion is by 

 stimulating the excretion of water by the shin. It has been frequently noted 

 that the steam bath is conspicuously grateful to the diabetic, although it 

 diminishes the secretion of urine; other patients report that they feel much 

 better during the hot season than during the cold. Among the remedies which 

 stimulate secretion by the skin, sweat laths and pilocarpin are to be consid- 

 ered ; the former certainly have transitorily an ameliorating effect. Permanent 

 and complete cure has not been observed; but decrease in subjective discom- 

 fort and diminution in the daily amount of urine have been noted. The same 

 is true of pilocarpin, polyuria decidedly decreasing with its employment (in- 

 jections of from 0.01 to 0.015 on two successive days). It is true that in other 



