DIABETES MELLITUS 
is one of the pathogenic conditions the treat¬ 
ment of which is often very unsatisfactory to 
the general practising physician. The fact 
that no actual curative treatment has yet been 
given to the world is discouraging, and the 
lack of improvement in the patient's condition 
causes despair and loss of faith in any 
measures adopted. 
The strict dietetic measures, which are so 
irksome to the patient, are often disappointing, 
this circumstance being largely due to the lack 
of care and thoroughness in making that re¬ 
stricted diet bearable to the patient. It is 
practically impossible for a busy physician 
to give such details the care and attention they 
require, and he has had to rely upon the 
patient's own ingenuity and self-abnegation, 
which in most cases amounts to very little. 
THE ONE CERTAIN FACT 
that stands out in the investigation of carbo¬ 
hydrate metabolism and the pathology of 
diabetes mellitus is, that the patient loses 
partially or wholly the power of assimilating 
carbohydrates, and that the unassimilated 
material passes into the blood and eventually 
into the urine. The presence of this carbo¬ 
hydrate matter in the blood causes the familiar 
symptoms which are so distressing. 
It often happens that a patient having 
sugar in the urine is ordered a starchless diet, 
and the physician, seeing the patient again in 
a few days, judges his condition as the result of 
a starchless diet. In many cases this is en¬ 
tirely misleading, as many circumstances may 
have occurred to upset the calculations. The 
patient may not have been faithful to the 
directions, he may have been taking so-called 
"gluten” food, he may have lost his assimi¬ 
lative power entirely, or he may have only 
partially lost it. 
There is abundant Clinical Evidence to 
prove that diabetes mellitus can be controlled 
and kept down, in a patient over 30 years of 
age, if the diet contains no more than the 
amount of carbohydrates (starch, sugar and 
dextrine) which he can assimilate. 
THE TOLERATION POINT 
can be easily ascertained in the following way. 
The patient should be instructed to diet ac¬ 
cording to the diet list on page 7 (separate lists 
can be had on application), for at least 2 weeks, 
using Casoid preparations to replace bread 
and cereals. His urine should then be quan¬ 
titatively examined and the result noted. For 
the next two weeks he should continue the 
same diet, but with an allowance of 1^ ozs. 
of ordinary bread per diem, after which 
another quantitative examination of the urine 
must be made. If the sugar secretion has not 
increased, another two weeks’ trial with 3 ozs. 
of ordinary bread per diem can be tried and so 
on until the toleration-point is ascertained. 
A PATIENT’S ALLOWANCE 
of starchy food should be kept within the 
toleration limit, and if the intelligent co-opera¬ 
tion of the patient is obtained, results will be 
satisfactory. The toleration-point should be 
ascertained again in a few months, as the as¬ 
similative power seldom remains stationary 
and frequently increases. Sudden Loss of 
Weight with no sugar secretion often denotes 
the increase of assimilative power. 
