The diabetic should live upon a diet which keeps his body-metabolism at its lowest, and for this carbohydrates are' necessary. There is no cure for the con dition; the treatment must simply be directed to prolong life. and this a rigid proteid diet is not capable of doing. Munson (Jour. Amer. -Med. Assoc., May 15, '97).
.An absolute diet without vegetables should not be given, as in bad cases it leads surely to more rapid accumulation of acids in the blood, and diabetic coma is an acid intoxication. Even in the lightest cases, however, for two or three weeks three or four times a year abso lutely, no carbohydrates should be taken, as thus the metabolic faculty for sugar which has been injured is given that strictly-physiological rest so conducive to its recuperation. Lee (Med. Record, -May 7, '98).
In diabetes the effoit now is to so spare the faculty for the absorption of sugar as to lead to its recuperation, and yet not to precipitate a fatal termination by feeding exclusively on albumins and so leading to increased acidity of the blood. For this the sugar-metabolic limits of the organism having been found by a series of urinary examina tions, these are never overstepped, a greater quantity of carbohydrates are never allowed than can be consumed, and then three or four times a year, for a period of two or three weeks, the pa tient is put upon an absolute diet, with all carbohydrates excluded. Leo (Phila. Med. J0111%, ..i1.1ar. 17, '98).
The proper dieting, is of the greatest importance in the treatment of diabetes. Drugs have practically no influence on the process. The benefit derived from a stay at some watering-place is ascribed to the diet, which consists exclusively of fat and proteid. saccharin we pos sess an excellent substitute for sugar, and one which can be taken for years with impunity. Notwithstanding the many preparations on the market, the proper substitutes for bread have not yet been found, for those which have been tried either become disagreeable to the taste after awhile or they are too rich in carbohydrates. If the condition permits the use of any bread at all, Graham bread is to be preferred. One should never forg,et that the diabetic needs more actual food than the well, since he loses so much, and underfeeding should be avoided. As with morphine,
it is generally bett,er and more agreeable for the patient to withdraw the forbid den.articles of food slowly than rapidly. The scales shmild be used freely to watch the body-weight. If the urine has been free from sugar for several weeks small quantities, say, 25 grammes (6 'ft drachms), of bread daily are per mitted, and the amount is increased daily 10 grammes (2 'A drachms) till 70 to 100 are reached, which is suffi cient for most. As soon as traces of sugar again appear the bread must be reduced in some and in others entirely withdrawn. II. Eichborst (Therap. Alonats., Sept., 1902).
The abuse of the albuminoids by dia betic patients may cause not only the usual disturbances, but it may also in crease the sugar in the urine, as Naunyn has justly remarked. It has also been noticed. that an exclusively-meat diet may bring about some particular dys crasia, ending in diabetic coma. This exclusive diet, which was formerly lauded by Cantani, is consequently not to be recommend.ed. It is very difficult to ab solutely deprive the patient of bread, so a small quantity, as small as possible, may be allowed, or, in place of this, an equally-small portion of potatoes.
Levulose can be given in moderate quantities in slight forms of diabetes, without injurious results as regards sugar-excretion, urine, etc. 'Utilized in the system, though' dextrose and cane siwar excreted. Orube (Zeit. f. klin. Med., B. 26, H. 3, 4, '95).
LLevulose may generally be given in small doses to patients suffering from mild diabetes; but, if small daily dose be exceeded, excretion of sugar increased without beilefit to patient. R. LEPINE, Assoc. Ed., Annual, '96.] In eases of diabetes the addition of a • small quantity of alcohol (1 to 21/4 °limps per diem) has no ill effect. In ca.ses where there is already cardiac weakness or vascular disease, alcohol should be used cautiously. Beer is for hidden, as it contains the most extractive !natters, which are chiefly carbohy drates. All sugar-containing liqueurs and sweet wines are, of course, forbid den. Wine, cognac, certain forms of brandy, etc., may be allowed. Hirsch feld (I3erliner klin. Woch., Feb. 4, '95).