The disease is essentially a chronic one, though death occurs, in some eases, with great rapidity. The younger the patient the more grave is the disorder. From six months to three or four years is the duration of the dis ease, and it terminates by exhaustion or by other induced diseases.
Consumption is liable to attack and carry off a diabetic person., Death sometimes occurs by coma (unconsciousness), diabetic coma, and then it may be sudden.
Treatment.—The chief treatment consists in regulation of the diet. All articles containing :rugar or starch (which is converted into sugar in the body) should be rigidly excluded. To show what substances may be eaten, because of absence of sugar or starch, and what may be drunk, as well as what ought to be avoided, because of the sugar or starch they contain the following tables from Pavy are given:— Thus the patient must deny himself sugar in every form, and he must leave ordinary bread, biscuits, potatoes, and sweet vegetables out of his diet. This may be done gradually by drop ping potatoes and taking only a small half-slice of bread well toasted, or bran bread well toasted. Special bread is made for the dia betic called gluten bread, made of flour out of which all the starch has been washed. It is unhappily not very palatable, and patients soon tire of it. Almond cakes may be used. For drinking, soda-water, or soda-water and cream is refreshing.
The patient should take regular moderate exercise, flannels should be worn, and warm baths frequently taken.
Many medicines have been tried, but none are very successful. Opium and ergot are pro bably the best, and may be taken in pill, con taining grain powdered opium and 2 grains ergotiue, one thrice daily. In many cases the use of opium ought to be pushed, but not without medical supervision.
The liquid extract of the seeds of Jambul the Java plum (Eugenia Jambolana Jambola num) is a drug worth a trial, in doses of 5 to 10 drops in water two or three times a day. Uranium acetate was spoken of also as sometimes curative, and in France a wine, pre pared with it, and called Vin Urano, has been much advertised.
It should not be forgotten that the regulation of the diet is the chief treatment, and that a return to ordinary diet, because of the irksome ness of a restricted one, is almost certain to restore the worst symptoms. Efforts should be made, by constantly varying the kinds of food used, of those recommended in the first list, to diminish as much as possible the feeling of loss because of the want of customary things.
Blood in the Urine (Thematuria and Menta tinuria). Blood may exist in the urine under a variety of circumstances. It may come from the kidney, from the ureter, from the bladder, or other parts of the urinary tract. If it come from the kidney it is more likely to be uni formly mixed with the urine, which has in con sequence a smoky colour, than when it comes from the bladder, when it is more likely to present the appearances of ordinary blood and to be less mixed with the urine. It may be passed
in clots. Congestion of the kidney, or inflam mation of various kinds, or the presence of stone may be among its causes, while growths or stone in the bladder commonly produce it. When it is in small quantity the smoky colour of the urine suggests its presence, and this may be most easily verified by discovering blood cor puscles in a drop of the urine examined by a microscope.
Paroxysmal Flmmatinuria is the term ap plied to a curious affection, due to exposure to cold, in which the patient, after complaining of uneasiness across the loins and chilliness, becomes extremely cold, is pale, has an attack of shivering, shortly afterwards passes urine re sembling porter, very dark coloured and muddy, because of the presence of blood. Sometimes sickness and aching in the limbs attend the attack, which soon passes off, but is liable to occur again suddenly after varying intervals. Sometimes the attacks occur after regular in tervals. The poison of ague has been said to have a part in the tendency to the disease.
Treatment for bloody urine depends on its cause. When it is coming in any quantity the pemon should be kept quiet in bed. Cold com presses may be applied over the loins if it is supposed to come from the kidneys, or over the lower part of the belly if it is supposed to conic from the bladder. If the discharge is profuse, 5-grain doses of gallic or tannic acid may be administered by the mouth every 5 or 6 hours while necessary, or 15 grains iron-alum dis solved in a tumbler of water should be taken in 12 hours. During the paroxysmal attacks the patient should be kept warm in bed. The prevention of the attacks is more easily ac complished than the treatment. Exposure to cold and wet should be avoided ; the person should be clothed in flannel ; and quinine and iron tonics should be taken.
In both kinds of cases, however, the deter mination of the causes of the disturbance is so difficult, and their recognition of so much importance, that no delay should be made in consulting a physician.
Chylous Urine (Chyluria) is a condition in which the urine is milky from the presence of chyle or lymph (p. 276), and clots, like size, on standing. It is a disease of tropical climates. In many cases the disease has been associated with a worm, the Filaria sanguinis hominis, occurring in the blood.
Suppression of Urine is the term applied when no urine is passed from the kidneys. It is to be distinguished from retention of urine (p. 411), in which the kidneys form urine which accumulates in the bladder. It is a very serious condition, occurring in the course of cholera, certain infectious diseases, and inflammations of the kidneys, and if continued leads to unemic poisoning (p. 400). In cases of hysteria sup pression of urine may last for some time with out any symptoms of uraemia.