DIABETES INSIPIDUS.
The treatment of this affection is entirely empiric, since its pathology is still a mystery. Electricity in every form has been tried, without marked benefit.
Extract of Valerian in large doses was employed by Trousseau. Ile administered a drachm three times a day, and in one case he gave r oz. daily. The nausea which follows is the great drawback. Ralfe administers io mins. Tincture of Cannab. Ind. with 6 drs. Tr. Valerian and 3o grs. Bromide at bed-time. Valerianate of Zinc in io gr. doses may be given in capsules, but it is doubtful if it has any valerian-like action.
Antipyrine has been reported as markedly successful in several cases. It should always have an early trial. The daily dose should begin with 3o grs., steadily increased till 6o grs. are reached.
Ergot is used by many as a routine treatment in full doses, and Nitro glycerin has been favourably reported upon. Suprarenal Extract has disappointed expectations. Amylene Hydrate in doses of about r dr. at night and Paraldehyde have their advocates.
Roberts, noticing how often the disease was relieved by the presence of some intercurrent inflammatory affection, was led to apply a large blister to the pit of the stomach with some benefit.
Morphia, Opium and Codeine generally do harm, but in a few cases they have proved useful. Iron, Strychnine, Gallic Acid, Creosote, Alum, Bella donna, Muscarine, Pilocarpine, Cream of Tartar, Nitre, Salts of Silver, Mercury, Arsenic, Zinc and Gold, Bromides, Iodides, Permanganate of Potash, and many other drugs have been at times found useful in diminish ing the amount of the urine. Some cases are upon record where, after
failure of all drugs tried, rapid improvement has followed a change of air to the seaside. Warm clothing should he insisted upon, and the general health carefully looked after, signs of emaciation being treated by Cod Liver Oil, and the usual remedies applicable in the treatment of wasting diseases.
Dietary should be generous, with few restrictions; any attempt to reduce materially the intake of liquids causes rapid diminution in the amount of water passed, but produces such intense discomfort and depres sion that, as a method of treatment, it has to be soon abandoned in each case. Often, however, good is obtainable by a very gradual diminution of liquids till the point is reached at which the bulk of the urine is greater than the intake of fluid, after which the quantity of fluid food is slightly increased. Where phosphaturia exists, Opium and Codeia may be tried for a short period, and then food rich in phosphates may be given, and wholemeal flour is indicated.