In 200 eases there were found 4 in temperate, 107 temperate, S9 total ab stainers, 69 opium habitiles. Antra (Indian Med. Record, june 1, '95).
In 607 persons engaged in manual labor or requiring great muscular and respiratory activity, no sugar was found in any case; in 100 persons eng,aged in intense intellectual work, sugar was found in 10. Worms (Bull. de 'Acad. de Med. de Paris, July 29, '95).
Diabetes appears more frequently in March, April, July, and November; in ereased mortality in winter, but not in relation with average temperature. Davis (Amer. jour. of the Med. Sciences, July, '95).
The increase of diabetes is much more pronounced among the wealthy classes than among the poor, the average in the poorer parts of the city being only 7 to 9 in 100,000, while in the wealthy quarters the average is 16 to 20. Ber tillon (Editorial, Modern Med. and Bact. Rev., Apr., '97).
Obe$ity, gout. and diabetes are closely related. Any two or all three of them may be present in the same person. The diseases are hereditary, and are espe cially prone to descend to those children that most elosely resemble their parents in external features. Certain individuals in whose family obesity is hereditary become obese despite a moderate diet and an active life. There must be some abnormity of the protoplasm of the cells. Uric acid is an abundant factor in the etiology of gout. In view of the fact that uric acid is a derivative of the nu clei of the cells, it may be inferred that in gout also the cell-protoplasm is in some way at fault. In diabetes there is likewise some defect in the cellular ele ments of the body—in the protoplasm. In the diabetic glycogen is found in organs in which normally it does not exist, and from this may be inferred a disturbance of the cellular protoplasm. ln those cases of diabetes in which the pancreas seems to be responsible the de fective activity of this organ gives rise to modification of the cell-protoplasm of the same nature as that which develops under the hereditary impulse. All three affections personally classed as general diseases of protopla `All, hereditarily trans missible. Wilhelm Ebstein (Dent. med.
Woch., Nov. 3, '9S).
The causes which we have so far men tioned are predisposing causes.
As to efficient causes of diabetes, acute infectious diseases cannot be considered in this category, for the affection does not come on after typhoid fever, eruptive fevers, etc. -With regard to malaria, sev eral French physicians have noted a temporary glycosuria after attacks of in termittent fever; but in malarial coun tries true diabetes does not appear to be any more common than elsewhere.
The question of syphilis will be re ferred to later.
The part played by contagion in dia betes is, so far, not based upon any very exact observations. The occurrence, said to be quite frequent, of diabetes in hus band and wife, has been a mooted ques tion.
Man and wife may both be diabetic. From an analysis of 2320 cases, 26 ex amples of such occurrence have been accumulated. Quite healthy persons, without hereditary predisposition, may become suddenly diabetic after attend ing to a diabetic for a time, living in the same room, sleeping with and espe cially kissing him often. In the light of these data, embodying somewhat over 1 per cent. of several thousand cases, the possibility of an infections nature in diabetes mellitus is strongly sug gested. Schmitz (Berliner klin. Woch., May 19, '90).
Twenty-six examples recorded where husband and wife both suffered from dia betes. These were examples chiefly of married females who had become sud denly diabetic after nursing a diabetic husband. There was no indication of hereditary predisposition. No family relationship between the patients, no excess of sugar taken in the food, and the patients had not suffered from gout. The question raised of the possibility of contagion or transmission of the disease.
The numerical relation between dia betic married couples and other diabetic eases is shown in the following: table:— or 1:93 Vs or 1.0S per cent. B. Oppler and C. Kiilz (Berliner klin. Woeh., Nos. 26 and 27, '90).