DIABETES MELLITUS, a disorder of nutrition, in which there is deficient oxidation of the sugar in the body, which permits of the storing up of large amounts of sugar in the blood. This is eliminated in part in the urine, and there constitutes one of the most positive findings of the condition. In European coun tries it is from three to five times as common as here, although statistics seem to show that it is on the increase in the United States. The symptoms vary very widely as the disease is often complicated with other nutritional dis eases such as albuminurea, tuberculosis and digestive diseases. There is an acute form of the disease which proves rapidly fatal, but in the majority of cases there is a gradual onset, during which increased urination and increased thirst are the initial symptoms. Following this, if the disease . progresses, the thirst still in creases; there is passing of large quantities of urine containing glucose; very marked increase in the appetite, amounting sometimes almost to voraciousness and gluttony; and an accompany ing progressive emaciation or the patient be comes obese. Appetite though usually ravenous may fail. The skin is dry and harsh; tempera ture is often below normal; the tongue is bright red and glazed; the gums may be swollen; and constipation is the rule though there may be serious diarrhoea.
As the disease progresses there are apt to be boils, abscesses, pimples, eczema, intense itching or cellulitis from slight injuries. Perforating ulcer of the foot may occur, and occasionally there is bronzing of the skin. Acute pneumonia is a frequent cause of death. Gangrene of the lung may also arise. In most cases, particularly in the young, there is a form of progressive in toxication due to the gradual retention in the body of acids which are not properly neutral ized by the body's protective agencies. There
is gradually progressive anaemia, headache, de lirium, great distress and marked hunger for air, which may be accompanied by blueness of the skin or by jaundice. Neuralgic pains are also frequent complications in diabetes. Arterio-sclerosis may be a result. In the young, especially, there is a liability to functional and structural heart diseases.
The cause of diabetes mellitus is a matter of much inquiry, but it would seem that it is a disease of a number of origins. Funda mentally, however, it is due, as implied at the beginning of this article, to some interference with the physiology of sugar-oxidation. This may result from disease of the pancreas, dis ease of the suprarenal gland, sometimes disease of the central nervous system, and occasionally disorder of the sympathetic system. The pancreas and the suprarenals are considered at the present time as the site of the chief changes leading to the production of this disease. The outcome is usually dark. In children, as a rule, it progresses rapidly to death. There seems to be an intimate relation between gout and dia betes mellitus, both aggravated by worry, busi ness troubles and mental overwork — hence eGouty Glycosuriaa of the old. Middle-aged people may live for many years, but instances of cure in true diabetes are quite rare. The treat ment is largely hygienic, and is extremely com plicated. At present time Dr. Allen's so-called (starvation treatments is uppermost. Diet and hygiene are the most important factors. Each patient having his idiosyncrasies, medical advice on the matter of diet is imperative. The patient, not the disease, needs treatment; hence general rules are more productive of harm than of good.