Further Notes on the Treatment of Diabetes

essential is to have the patient under observation for two or three days, during which he lives his ordinary life, and partakes of his ordinary food. In this period the twenty-four hours urine is measured, the total sugar estimated, and, if possible, the blood sugar calculated. Should the case be a severe one, the patient elderly or debilitated, and any considerable quantity of diacetic acid present, the diet restriction should be gradual. All fat should first be omitted, then the protein, and finally the carbohydrate halved daily until only ten to fifteen grams daily are being taken. Complete fasting can then be enforced until the urine is sugar-free. Should the case be not so severe the fasting may be commenced at once. Even this fasting may, with the exercise of a little ingenuity, be rendered much less arduous. For example, tea and coffee without sugar or milk are allowed freely (a slice of lemon may be used), as also lemco, bovril or clear soup, water and soda water. Any green vegetables of the 5 per cent, group may be given, provided they are boiled twice or thrice, that is to say, in three successive changes of water. It has been said tlhiat they are boiled until nothing but the smell remains! Be that as it may, twelve ounces of twice boiled 5 per cent, vegetables, flavoured with bovril and the ordinary condiments, give great mental comfort to the patient. Generally by the morning of the third day the patient is free from sugar and feels remarkably better. The thirst disappears, the general irritability diminishes, and the constant rising from bed during the night is no longer