Eight diabetic patients could com pletely oxidize levulose in daily amounts of from 6 to. 25 drachms. Levulose not only does not increase, but rather dimin ishes, the amount of nitrogenous output, both urine and fieces being examined. E. de Renzi and E. Reale (Wiener med. Woch., '97).
There are carbohydrates that seem to have little influence on glycosuria, such as levulose, inulin, and marmite. Cer tainly the rule is that the group of sugars whith deviate polarized light to the left are less injurious than those that deviate it to the right. Bouchard (Sem. ..N.f6d., Mar. 26, '97).
Flour made from edible pine-nuts recommended for diabetics. It is fine, slightly yellow, bland in taste, contains no starch, and 7 per cent. of cane-sugar. If raised with yeast, sugar is decomposed so that only ft fraction of 1 per cent. can be found. Bread and cake made from it are relished, and it is an agreeable sub stitute for wheat-bread. The flour is known as the "Chicago Sanitary Flour." N. S. Davis, Jr. (Jour. Amer. Med. Assoc., .Nov. 5. '98).
Strict milk diet in diabetes combined with hydrotherapentics, systematic exer cises, fresh air, and sunshine advocated. Winternitz and Strasser (Centralb. f. innere Med., Nov. 11, '99).
Diabetics must be taught to use fats in abundance. They are the only sub stances that can succeed in stilling the craving for the starches and sugars and can properly replace them. Editorial (Med. News, Feb. 17, 1900).
Thirty-four different kinds of potatoes subjected to examination, the most nota ble result of the proceeding being that the potatoes employed for diabetic feed ing should be fresh and mature, and that the central portion of the tuber, being the most watery, the richest in nitroge nous matters, and the poorest in starchy ingredients, is the best suited for the purpose. A. Masse (Klinisch-therap. Woch., Oct. 7, 1900).
Ebstein has recently very highly rec ommended aleuronat bread, which con tains a much greater proportion of vege table albumin than any other thus far recommended for diabetics, and which may consequently be taken in larger quantities. With regard to drinks, the abuse of beer, alcohol, and wine should be forbidden.
The above are the main features in the diet; it is necessary to conform to them as far as possible, at the same time avoiding all exaggerations.
Sugar-free milk contains approxi mately 3 per cent. of proteid and 5 per cent. of fat. If 3 pints are taken in a day, the food-value amonnts to 990 calories, or nearly one-third of the total amount required, while the amount of fat which the patient obtains is equiva lent to fully 3 ounces of butter. In eases in which a small amount of carbo hydrate is desirable, it is sometimes best to substitute sugar-free milk, and give carbohydrates in the form of potatoes or bread, as this enables the patient to ingest a larger amount of fat. Robert Hutchison (Lancet, June 22, 1901).
In the severe forms of diabetes, the diet must naturally be much more lim ited, except in cases where coma appears imminent. The marked reaction of the urine -with the perchloride of iron, and especially the diminution of the appe tite, are the chief premonitory symptoms of this danger. In such cases every one is agreed that it is well to abolish the restricted diet.
Opium is of temporary service, at least, but I have never found it beneficial for any length of time. It causes a' reduc tion in the quantity of sugar. Villemin advised the addition of belladonna. I have never been able to convince myself of the advantage of its use, and have found it to cause dryness of the throat. Antipyrine is sometimes most useful; it frequently diminishes excessive polyuria and reduces the sugar.
The value of antipyrine in three cases of long standing (one of twenty years') verified. The results were immediate, and all traces of the condition promptly disappeared—in one case permanently, in another for a long time after a. with drawal of the remedy; in the third ease the quantity of urine at once rose to its former amount upon the withdrawal of antipyrine, but upon readministration fell again. Beginning the treatment, the medicament should be given to the amount of 31 grains, per diem, this amount increased by 15 '/, grains daily until 1 'A drachms are reached or the amount of urine diminished; and after eight days should be omitted in order to see if the results are permanent. Opitz (Dent. med.-Zeit., Aug. S, 'S9).