DISEASE, p. 399.) The tests for albumin in the urine have been mentioned on the preceding page.
Polyuria (Diabetes Insipidus) is a disease characterized by the passage of large quantities of urine of low specific gravity (1001 to 1010), and without the presence of albumin or other unhealthy constituent.
It is a curious and rare disorder, its cause being not understood. It is hereditary and has been known to be transmitted through four generations, and is related to true diabetes, in which sugar is present in the urine. It may occur at any age and to either sex. It may exist in the newly-born child, and is rather more common in early than in later life. It is supposed to be connected with tuberculosis (Sect. XVII.), disease of the brain, and intem perance. Its supposed connection with nervous disease is strengthened by the fact that the famous French physiologist, Claude Bernard,. who found that a puncture in the floor of the fourth ventricle of the brain (p. 135) at a particular spot occasioned true diabetes, found also that a puncture in a slightly different situation produced polyuria.
Its chief symptom is the excretion of large quantities of urine, even larger quantities than in true diabetes. The urine is of low specific gravity and contains no albumin or sugar. Pailfuls of urine may be passed daily, and the person is tormented by constant desire to drink, and to pass water. Thirst is present, and occasionally the appetite is great. A patient of the French physician Trousseau, was paid by some restaurant keepers not to dine there, since the quantity of bread (sup plied without extra charge) he consumed was enormous. Some suffering from this disease can drink large quantities of intoxicating liquors without being in any way affected thereby. In many cases no other symptoms accompany the disease, and the patient may live to a good age. In other cases impaired health follows, though death is usually owing to some other affection.
No treatment of special value is known. The diet should be regulated, and tonics (quinine, iron, and strychnine tonic—see PRESCRIPTIONS) administered. Water should not be withheld. Ergotine, in doses of 2 grains twice or thrice daily, and continued for some time with sional intervals, might prove of benefit.
Diabetes Mellitus (from Greek,dia, through, and baino, I flow, and melitta, a bee; Glycosuria --sugar in the urine) is a disease of which the chief symptom is the presence of sugar in the urine.
Its cause is not known. Claude Bernard found that it might be artificially produced in animals by puncturing the floor of the fourth ventricle of the brain. It is sometimes hereditary and may be present at any age and in both sexes, being most common in adults from 26 to 60 years of age.
The symptoms are the passing of a constantly excessive quantity of urine, which gradually becomes more and more abundant, thirst, ex cessive appetite, dry harsh skin, and gradual loss of flesh and strength. These symptoms usually increase slowly.
The urine is pale in colour, with a peculiar sweetish heavy smell ; from 8 to 20 or 30 pints may be passed daily ; it is of high specific gravity (1030 to 1040); and the presence of sugar is sometimes indicated by the patient noticing that it is attractive to flies, bees, &c. It rapidly ferments if kept in a warm place. The presence of sugar is determined by the tests mentioned on p. 406.
The large quantity passed causes frequent calls to pass water. The thirst cannot be satis fied, and is accompanied by a parched and clammy condition of mouth and throat.
Appetite is often voracious, though in the later stages it may be lost. The tongue is red and irritable, the gums inflamed and the teeth liable to decay. Costiveness is common.
The body is wasted, the strength reduced, and languor and weariness produce disinclina tion to exertion.
The harshness and dryness of the skin is marked; there is tendency to boils, and wounds do not readily heal. Failure of sight from the formation of cataract is frequent. While these are the symptoms of a marked case, sugar may exist in the urine without any prominent symp tom leading to its detection. Specially is this liable to be the case when the disease begins in persons advanced in life. In such cases an in tolerable itching about the genital organs may be the symptom which leads to an examination of the urine and the detection of sugar, of which no other marked symptom is present. Stout people advanced in life may thus be affected without losing their stoutness, in whom dys pepsia and general weakness are the chief com plaints. In such patients recovery is much more probable than in the fully evident dis ease, and the complaint is in no way so dis tressing.