ETIOLOGY OF DIABETES MELLITUS GEOGRAPHICAL DISTRIBUTION ; CONDITIONS OF NUTRITION.
Diabetes mellitus is found in every country, but apparently it does not prevail to the same extent in all. It is difficult to obtain reliable figures, for the statistical material of different countries bear ing upon this point has not yet been sufficiently worked up, and we have to gather our information from the personal experience of indi vidual writers rather than from national tables of morbidity. South ern Italy and India are regions in which diabetes mellitus appears to be especially frequent. Many writers refer the prevalence of the disease in these countries to the preponderance of vegetable food, and particularly of saccharine fruits, in the diet of the inhabitants ; but it is very questionable whether such a view of the relation of cause and effect is justifiable, for the use of vegetables as the main food of the people is widespread throughout the globe, and is the rule in many regions in which diabetes appears not to prevail to any un usual extent. On the other hand, Sweden is counted among the lands
in which diabetes is very common, although its inhabitants do not indulge in carbohydrates to any excessive degree. Furthermore it may be said that in Germany at least, and apparently in other coun tries also, the well-to-do members of the community suffer from dia betes in far larger proportion than the poorer classes. When we consider the difference in the food of the two classes, we must admit that this fact argues very strongly against the theory that there is any definite relation between the occurrence of diabetes and an ex cessive consumption of carbohydrates.
may be asserted with positiveness concerning the Hebrews scattered, throughout Europe. The causes for this special predisposition of the Jews are as obscure as are other racial peculiarities, and we can offer only conjectures.