“ In diabetes insipidus there is constant thirst and an excessive flow of urine, which, however, is not found to contain any abnormal constituent. Its effects upon the system are often similar to those of diabetes mellitus, except that they are much less marked, the disease being in general very slow in its progress. In some cases the health appears to suffer very slightly. It is rarely a direct cause of death, but from its debilitating effects may predispose to serious and fatal complications. It is best treated by tonics and generous diet. ”

“ The best diet can only be worked out experimentally for each individual patient. But in every case, if drowsiness or any symptom suggesting coma supervene, all restrictions must be withdrawn, and carbohydrate freely allowed. The question of alcohol is one which must be largely determined by the previous history of the patient, but a small quantity will help to make up the deficiencies of a diet poor in carbohydrate. Scotch and Irish whisky, and Hollands gin, are usually free from sugar, and some of the light Bordeaux wines contain very little. ”

“ A patient must never pass suddenly from an ordinary to a carbohydrate-free diet. Any such sudden transition is extremely liable to bring on diabetic coma, and the change must be made quite gradually, one form of carbohydrate after another being taken out of the diet, whilst the effect on the quantity of sugar passed is being carefully noted meanwhile. ”

“ Boils, carbuncles, cellulitis and gangrene are all apt to occur as life advances, though gangrene is much more frequent in men than in women. Diabetics are especially liable to phthisis and pneumonia, and gangrene of the lungs may set in if the patient survives the crisis in the latter disease. Digestive troubles of all kinds, kidney diseases and heart failure due to fatty heart are all of common occurrence. Also patients seem curiously susceptible to the poison of enteric fever, though the attack usually runs a mild course. The sugar temporarily disappears during the fever. ”

“ The teeth are loosened or decay, there is a tendency to bleeding from the gums, while dyspeptic symptoms, constipation and loss of sexual power are common accompaniments. There is in general great mental depression or irritability.
Diabetes as a rule advances comparatively slowly except in the case of young persons, in whom its progress is apt to be rapid. The complications of the disease are many and serious. It may cause impaired vision by weakening the muscles of accommodation, or by lessening the sensitiveness of the retina to light. ”

“ Numerous medicinal substances have been employed in diabetes, but few of them are worthy of mention as possessed of any efficacy. Opium is often found of great service, its administration being followed by marked amelioration in all the symptoms. ”

“ Hence it is recommended that such articles as bread, potatoes and all farinaceous foods, turnips, carrots, parsnips and most fruits should be avoided; while animal food and soups, green vegetables, cream, cheese, eggs, butter, and tea and coffee without sugar, may be taken with advantage. As a substitute for ordinary bread, which most persons find it difficult to do without for any length of time, bran bread, gluten bread and almond biscuits. ”

“ But hypodermic injections of pilocarpine stimulate the flow of saliva, and thus relieve the dryness of the mouth. Constipation appears to increase the thirst, and must always be carefully guarded against. ”

“ He suffers from increasing muscular weakness, the temperature of his body is lowered, and the skin is dry and harsh. There is often a peculiar flush on the face, not limited to the malar eminences, but extending up to the roots of the hair. ”