Among 770 cases of diabetes observed there have been 9 instances of man and wife suffering from the disease: 1.19 per cent. When all the cases are excluded in which there is a family history of the disease, or a history of any of the well known etiological antecedents. the cases t.emaining are so few that it seems prob able that the occurrence is accidental, or that both man and wife have been subjected to the same antecedents. H. Senator (Berliner klin. Woch., July 27, '96).
In a series of 5000 cases LS per cent. of conjugal diabetes found. The facts thus far published do not shed much light on the two theories of causation now held, viz.: (1) that the ordinarily accepted causes of dia,betes are active in both husband and wife, and (2) that the disease is contagious. Cases have been reported with almost conclusive evidence of contagion, but the na,ture of the con tagion and how it is conveyed are mys teries. Schram (Med. News, Jan. 1, '9S).
Diabetes considered contagious. Opin ion based on cases of conjugal diabetes, as well as on those of persons becoming diabetic as a consequence of daily inter course with diabetics or handling things made use of by them. M. Ledieu (Gaz. Hebdotn. de Med. et de Chir., Oct. 2, '9S).
This coincidence, if it actually is of frequent occurrence, would be an argu ment in favor of contagion. The ques tion is now being studied.
Nervous affections arc certain causes of diabetes. The disease is often met with in people who have suffered from much anxiety or worriment.
Diabetes should be classed among the neuroses; its varied phenomena result by reflexes from the nervous system. The disease obviously arises in the sympathetic chain which controls the secretory functions of the kidneys. J. Blake White (Amer. Medico-Surg. Bull., '95).
Diabetes also occurs -very frequently where there has been traumatism of the head. According to certain statistics, 2,0 per cent. of all cases of diabetes are due to this cause. It is possible that this proportion may be exaggerated, but I am willing to admit that there is surely one case of traumatic diabetes in thirty diabetic patients.
The traumatisins most often followed by diabetes a,rc those affecting, the head (25 in 45); sometimes also those affect ing the vertebral coliunn. Cerebral dis turbance mentioned twelve times. Sugar does not always appear in the urine im mediately after traumatism; if the dia betes succeeds rapidly to traumatism, it is almost always mild; on the con trary, almost all the uncured cases of traumatic diabetes begin late. Progress
is at times rapid; radical cures have been observed fairly often (14 cases out of 45), but they seldom take place where diabetes has persisted more than six months or a year. Bernstein-Kohan (These de Paris, '91).
Review of 212 cases of traumatism of the head admitted into the Boston City Hospital within thirteen months. Ranged in five classes: (1) wounds of the scalp; (2) wounds with denudation of the bone; (3) commotion, including cases followed by loss of consciousness, but without fracture; (4) fracture of the vault; (5) fracture of the base. Of the first class there were 84 cases, 5 of which, or 6 per cent., presented glycosuria; in the sec ond class, 43 cases, 4 with glycosuria,— 9 per cent.; third class, 40 cases, 1 with glycosuria,-2.5 per cent.; fourth class, 24 cases, 5 with glycosuria,-20.8 per cent.; fifth class, 21 cases, 5 with gly cosuria,-23.8 per cent. In all, 20 cases of glycosuria in 212 cases. F. A. Hig gins and J. B. Ogden (Boston -.1.1ed. and Surg. Jour., Feb. 28, '95).
Since the time of Claude Bernard we are aware of the fact that lesions of the floor of the fourth ventricle are particu larly liable to give rise to diabetes. Sev eral cases have been observed in man. Lesions in various parts of the encepha lon may bring about the same result. It is extremely probable that syphilis is not a cause of diabetes, except through the influence of diffuse lesions of the nerve-centres. There is consequently no syphilitic diabetes, but a diabetes de pendent upon cerebral lesions, whether due to syphilis or any other cause.
Out of twenty-seven records of exam ination of the brain in eases of diabetes mellitus, the organ normal in but five instances, the abnormalities consisting most frequently of cedematous brains with thickenings of the membranes. Less frequently the organ was anmmic, cystic, particularly in the frontal lobes, in the pons, and in the medulla.. Care ful examination with the microscope failed to indicate any histological changes, except in one instance where the capillaries of the vagus nucleus seemed to be abnormally numerous and full of blood. Saundby (Med. Chron icle, Jan., '90).