Paralysis of the intrinsic muscles is very rare. Paresis of the abducens some times occurs; also a combined paralysis of the motor oculi, which gives rise to imperfect lateral motion of both eyes. A nuclear origin is evident in these cases.
Gelle states that suppuration of the ear is not rare in diabetics. The progress of acute otitis is the same as that served in gout: rapid tumefaction, trusion, and redness of the tympanum.
During the second day severe pain, and afterward abundant suppuration.
Case of otitis media diabetica due to micro-organisms, diabetes having lowered vitality of tissues. Primary in tympanic cavity and secondarily a mastoiditis. In mastoid disease urine should always be examined for sugar. Davidsohn (Ber liner klin. Woch., Dec. 17, '94).
Inflammation of the mastoid is very frequent in diabetes mellitus. R. A. Urquhart (Med. News, Mar. 21, '96).
Two cases of acute mastoiditis in per sons suffering from diabetes mellitus. In the first case, the patient, a woman aged 50, induced the acute ear inflam mation as the result of snuffing salt water up the nose. At first she made good progress under treatment. Soon, however, began to complain of consid erable pain in the right half of the head, with continued discharge, renewed pul sating tinnitus, and commencing mastoid tenderness, until it became requisite to open the mastoid process. The interior of the process was found made up of small cells, in many of which were un healthy granulations.
In the second ease, the patient, a man aged 5S, had suffered from diabetes for about one year. The attack of middle ear inflammation was induced as the result of influenza, and was soon com plicated by mastoid involvement. When opened, extensive bone disease was found present. J. E. Sheppard (Med. News, May 2, '96).
Bouchardat dwells upon the diminu tion of the memory and the existence of a growing indifference; the loss of apti tude for any intellectual work, a tend ency to anger, melancholy, and hypo chondria. It appears to me that this author has laid the colors on rather heavily in painting his picture; mental symptoms are not usually met with in diabetic subjects independently of the many cases in which heredity plays an important part.
Sugar in the urine is not at all com mon among the insane. Forty cases ob
served who had dia,bctic relations, 10 of them having diabetic parents or grand parents, 14 having diabetic brothers or sisters, 12 having aunts or uncles and 3 cousins suffering from this disease. Besides these there were 12 insane pa tients who bad insane and diabetic rela tives and 10 patients who were both insane and diabetic. Nearly all the cases of insane diabetics were affected with melancholia. The patients who had been diabetic and had then become in sane had almost all lost some or all of the symptoms of the diabetes during the period of their insanity. Mallet (Bull. de la Soc. Anat., Nov., '90).
Diabetes is a disease which often shows itself in families in which insanity pre vails; the two diseases are certainly found to run side by side, or alternately with one another, more often than can be accounted for by accidental coin cidence or sequence. Maudsley ("Pathol ogy of Mind," p. 113, '79).
The psychoses which develop in the course of diabetes usually take the form of melancholia. It is rarely that mani acal excitement is observed, circular in sanity being oftener seen. Finder (In augural Dissertation, '92).
Three eases of diabetes seen coin Plicated with mental disturbances. In the first case there was melancholic de pression with suicidal ideas; in the sec ond, mental debility; and in the third considerable pruritus vulvl-e with gen eral uneasiness. In all three cases there were no hereditary influences. S. Ierzy kowski (Nowiny Lekarske, July, Aug., '93).
Investigation carried on at the Ban stead Asylum and extending over a period of eighteen months. Between the llth of January, 1894, and the 25th of June, 1S95, there were (excluding transfers) 26S males admitted to the asylum; and in 175 of these an examination of the urine NVIIS made within forty-eight hours after admission. in 12 instances, or in 6.85 per cent. of these 175 eases, sugar was almost certainly proved to be pres ent. The following table indicates the varieties of mental disease under which these admissions labored, and the dis tribution among them of the 12 exam ples of glyeosuria:— C. Hubert Bond (Jonr. of Mental Science, Jan., '96).