Diabetes mellitus and its dietetic treatment

OBSERVATION VII. Baron Archpriest Girolamo M. di G., from Andiano (Lecce), 52, was sent to me by Doctor Stasi from Spongano, after Doctor Voccoli would have submitted for some time to my cure. Two of his sisters had died of phthisis; himself was thin, prone to intermittent fevers and digestive troubles, which hunting had cured him. At 32, he entered the seminary; soon after was resumed by his acid dyspepsia and coughing up blood; he ate vegetables and fruits, eating meat only exceptionally. When I saw him, he had been suffering from thirst with polyuria for a year; since the same time, he ate and digested well. Voccoli had noticed the presence of sugar, and ordered my treatment; under its influence the health of the patient improved very quickly; the thirst and the polyuria disappeared: the sugar diminished very rapidly. But the bowel pains returned and the sugar increased with each new attack, oscillating between 30 and 40 gr. per liter. Dr Voccoli noted that the glycosuria disappeared left, or nearly four hours after dinner, only to reappear very abundantly three hours before dinner the next day. The gastro-intestinal catarrh treated and improved, the anti-diabetic cure succeeded very well: but the sugar reappeared as soon as the patient ate bread. Through all these tests, the general condition was better: the patient, 61 kilog. and a half, had arrived at 63 kilog. in three months. It was there when I saw it, in April 1871. I did nothing but dismiss the last vestiges of flour that the patient had kept in his diet, and after several months of treatment, he could return to use with impunity, moderate bread. This very intelligent patient still checks the state of his urine daily.

OBSERVATION X. - Madame M., from Malta, 52 years old. Living almost exclusively on flour, fruit and pasta, suffering for a long time from thirst and polyuria, she has become notably thinner over the past two years; nine months ago diabetes was recognized; the patient was subjected to my treatment, which was not sufficiently rigorously followed. I saw her in consultation with Professor Cesare Olivieri and Doctor JB Sammut, English doctor: we discovered in her a uterine epithelioma. The urine, analyzed by Primavera, gave: 4 liters per day, specific weight 1032, 400 gr. of sugar per day (May 8, 1871). Immediately subjected to the rigorous cure, from May 14 there was no more polyuria, nor thirst, and the urine, with a specific weight of 1026, contained only 25 gr. of sugar per day: on the 22nd, they no longer contained sugar, and weighed only 1026. The urine remained thus, even after the patient had returned to eating sweet fruits, and especially oranges, until the moment of her death, which occurred a long time later, from her uterine tumor.

OBSERVATION XIII. - M. Raffaelle de P., from Pianella (Teramo), a staunch amylivore, diabetic for a long time, with 50 gr. of sugar per liter, was submitted to my cure on March 12, 1872: very rigorously observed only until March 30, when the patient began, but with much moderation, to eat starchy foods. The urine analyzed on April 22 and May 12, 1872 had a specific gravity of 1013, and was absolutely lacking in sugar. Although the patient had, so to speak, never eaten meat before this treatment, he was very well: the cure was maintained for a whole year. In May 1873, having become diabetic again, after another abuse of flour, he recovered again by a short resumption of treatment. In January 1874, his urine was still free of sugar.

OBSERVATION LXI. - M. Guiseppe d'A., Priest, 56 years old, from Acireale. According to the report of his attending physician, the distinguished doctor Gaetano Vigo, this patient has long abused flour and sweet dishes, and ate a lot while burning little, thanks to his way of life. After the death of his mother, which happened on February 14, 1871, and which grieved him a lot, he began to experience a great dryness of the mouth, with thirst, polyuria, and general prostration of strength: he also noticed that a few drops of urine which had fallen on black cloth, left a viscous white stain there. The chemical examination of the urine was not made until 1872, when the patient consulted Doctor Vigo, who found him notably emaciated, weakened to the point of not being able to take a short walk, and who observed in the urine, the specific weight of 1038, about 120 gr. of sugar per liter. The patient then followed the rigorous treatment prescribed by Doctor Vigo, and the urine became free of sugar; but he did not want to continue it beyond 25 days, and still indulging in the abuse of flour and candy, he soon relapsed into melituria, and more seriously than before. The urine reached the specific weight of 1042. The patient resumed cure, and, encouraged by Doctor Vigo, who understood the culmination of my therapeutic conception in this disease, he followed it this time in all its rigor, during four whole months, during which the weight of his body increased by 4 kilogr. Since August 10, 1872, sugar has not reappeared in the urine, the specific weight of which hovered around 1033, and the patient enjoyed the best health, although he had returned, this time with more moderation, to the use of strawberries. I really enjoyed receiving a letter from Dr Vigo, which expressly confirms my opinion as to the frequency of diabetes in these regions, a frequency which is directly related to poverty, especially since “ starchy or sweet food is almost exclusive, even for the upper class. And very cleverly, Doctor Vigo adds that idleness can greatly contribute to the development of diabetes; I believe that this is very probable, on account of the slowing down which idleness brings about in material renewal, in combustion in general, and, in amylivores, in the combustion of hydrocarbons, or of sugar. 

OBSERVATION LXII. MB, from Trani, client of the brave doctor Nanula, who noted the existence of diabetes in him, with 25 to 30 gr. of sugar per liter: the patient ate mainly starchy foods, and suffered from a notable general weakness, with polyuria and ardent thirst. After fifteen days of treatment, the urine still contained 15 gr. of sugar per liter, but they had decreased in quantity, and the state of strength was better: after a month, the sugar had completely disappeared: the patient remained healthy, regained his strength and was overweight: according to the latest information, he continues to enjoy the best health, although he has returned to diet mixed. 

OBSERVATION LXIII. - MG lawyer, from Trani, 60 years old, amylivore par excellence, was introduced to me as diabetic by Doctor Nanula, about three years ago; great prostration, impotence, thirst and especially troublesome polyuria. The urine contained 30 to 35 gr. of sugar per liter. Subjected to my cure, which he followed rigorously for two months, the urine became free of sugar; he rapidly improved in strength and nutrition, and resumed his pleadings in court with all the ardor of his best years. The urine examined again by the the patient remained healthy, regained his strength and was overweight: according to the latest information he continues to enjoy the best health, although he has returned to mixed food. Doctor Nanula these days are sugar free, although for several months he has been eating everything. 

OBSERVATION LXIV. M. Domenico Castronuovo, doctor from Carbone (Basilicata), 52 years old, almost exclusive amylivore, ill since October 1873, with unusual and increasing weakness of the lower limbs, virile impotence, aridity of the mouth, was recognized as diabelic by the doctor. Maturi, and on his advice began the treatment, rigorous meat diet (accompanied by hydrotherapy). On December 17th, the quantity of urine was reduced almost to normal, and Doctor Maturi observed by repeated analyzes the gradual decrease in sugar. The rigorous treatment was continued until January 30, 1874; after this day, the patient feeling cured returned to the mixed diet, and returned to it a little too abruptly, for he immediately allowed himself the use of bread, pastries, even sweetened coffee - and this above all because of the not very flourishing conditions in which he found himself, and which did not not allowed to maintain any longer the absolutely meaty diet. Nevertheless he was doing well, his strength was increasing: he was completely recovered. Towards the first days of February, he presented to the clinic, where he was received as a further observation of the disease. It was doing very well with the ordinary mixed regime, its temperature oscillating around 36°, 5 C .; with 64 to 68 beats, and 12 to 16 breaths per minute, the urine was kept completely free of sugar, its specific weight varied between 1022 and 1025, and its quantity sometimes exceeded, sometimes was not reaching one liter per 24 hours. On March 5, the patient left the clinic in the best condition. - This patient is cured rather quickly because he began and followed the rigorous cure soon after the onset of diabetes, while this one was still in the period of beginning diabetes. 

OBSERVATION LXV. Luigi B., 31 years old, merchant from Soriano (province of Rome). Suffering from great thirst and polyuria, with hunger and growing general weakness, weakness also of the reproductive organs, he was received at my clinic on March 5, 1874. He never ate only a little meat, but ate mainly flour. , especially abusing sweet pasta; he had neither moral emotions nor wounds: for ten years he had suffered a burning sensation in the epigastrium, which disappeared when several glasses of rum, some belching: these sufferings disappeared with the onset of diabetes. He suffered mental distress, but it was long after the existence of diabetes was discovered. He lost his father to phthisis. - At the clinic, he presented more than two and a half liters of urine within 24 hours; their specific gravity was 1042; they contained 277 grams of sugar per day. On March 10, he was put in treatment, he was given only meat, with lactic acid in water, and alcohol mixed with water, instead of wine: on March 11, he only eliminated 1400 cent. cub. urine, with a specific weight of 1021 and 15 grams of sugar per liter, about 22 grams per day. On March 12, Fehling's solution already indicated the disappearance of the sugar; the quantity of urine was 1970 CC, their specific weight 1015. - The urine remained free of sugar, their quantity oscillating between 1200 and 1700 CC, and their specific weight between 1018 and 1023. The temperature of this patient was maintained throughout his stay in the clinic between 36 °, 2 and 360.5 C .; only once did it rise to 370.9 C. due to a temporary febrile attack: the pulse oscillated between 54 and 74, rarely reaching 70 or 72; breaths were almost always a little frequent, between 20 and 24, without any lung disease. - The patient left the clinic on April 3, in the best state of health and strength: for some time he had returned to a moderate mixed diet.

OBSERVATION LXVI. - Mr. Francesco S., 60 years old, owner in Castellana di Bari, diabetic for a year, following abuse of flour and fruit, stubborn smoker, and gouty, was subjected to the rigorous cure by Doctor Nicola dell'Erba in November 1872. He was then 50 gr. of sugar per liter, with a polyuria of 5 to 6 liters per day; ten days after the start of treatment the urine was normal in quantity and quality, and all diabetic symptoms had disappeared. After a very rigorous cure, prolonged for two months and regularly followed, and a rationally graduated return to mixed food, he was able to return to the use of flour, although in moderation: even today he enjoys better health. 

OBSERVATION LXVII. - Mr. Carmine di F., from Alatri (prov. Of Rome), 54 years old, diabetic by abuse of flour since January 1872, resorted to the treatment of Dr. Raffaele Giorgi, when he suffered from an unquenchable thirst with discolored urine, of sugar (not dosed). Doctor Giorgi, after recognizing the diabetes, submitted the patient to my treatment, absolute meat diet and lactic acid; Only six days later, he examined the urine, he found only a few traces of sugar there: however the patient already felt improved: he was stronger, and no longer experienced the symptoms peculiar to diabetes. After 34 days of very rigorous treatment, the patient no longer being able to submit to such great penance, Doctor Giorgi allowed him to use bread in moderation; the urine remained free of sugar. Seeing him two months later, this patient presented normal urine, and was doing well anyway. From what the doctor wrote to me. Giorgi, in June 1874, the patient continued to do well; her urine remained normal. 

OBSERVATION LXVIII. - MN N., owner in Chieti, 40 years old, major consumer of hydrocarbons. In 1872 he suffered from eczema; in May 1873, he began to experience an extraordinary general prostration, especially a weakness of the lower limbs, with simultaneous emaciation, intense thirst, inextinguishable, and emission of very abundant urine: the morale was also affected, the patient became uneasy. , irascible, which he was not previously. In the first days of July 1873, talking with two distinguished doctors, he made them suspect that it was a question of diabetes mellitus: the urine was examined, and it was found that their specific weight was 1033, that they contained 40 gr. of sugar per liter, and that it was emitted 3 liters per day. Condemned to the meat diet, the sugar completely disappeared in three days, the specific weight of the urine fell to 1020, and from the first day of the treatment their quantity had fallen back to normal. Only the general weakness increased with the meat diet, a fact which is observed in several cases (but not in all) at the beginning of this radical modification in the diet, to give way later to a progressive increase in strengths. The cure was interrupted for ten days, and we saw the quantity of urine increase a second time, the sugar reappearing there, and their specific weight go up to 1030. After that the most rigorous treatment was resumed, and continued for six months: the last three months it is softened with a little grass. The sugar quickly disappeared from the urine again, and after six months of abstinence from all starchy or sweet foods, months without any trace of sugar reappearing in the urine, which, on the contrary, showed itself to be richer than before in uric acid and urates, since the patient had eaten everything. The latest news on this patient was communicated to me by Doctor Paolucci, my clinical coadjutor (I had them in September when I was correcting these tests); they confirm his complete good health, and the absolute absence of sugar in his urine. 

OBSERVATION LXIX. - Monsignor B., bishop of C., 49 years old, ate mainly hydrocarbons, and, without any other known cause, had been ill for some time, suffering from thirst with polyuria, general debilitation and mediocre weight loss, because he was fat before he got sick. His urine showed, in Primavera on January 27, 1874, a specific weight of 1033, an amount of 6 to 7 liters per day, and contained 100 gr. of sugar: 600 to 700 gr. per 24 hours. He submitted to the rigorous treatment, less according to the advice of the doctors, than by his own conviction, for he had been aware of our treatment, and had been able to realize, thanks to his great intelligence, of the nature of the disease and the curative method. At first, he wanted to experiment on himself the value of our treatment, and tried a little bread, after several days of absolute meat diet: but the constant appearance of sugar after each attempt, because this intelligent bishop had learned wonderfully at making use of chemical reagents, decided him to follow the most rigorous regimen for three consecutive months; from March 1 to May 30, for three full months, he followed him without the slightest interruption, with all the rigor I could demand. In June, he began to eat grass, bran bread, and drink wine, always examining the urine, which remained free of sugar; on June 23, they were again examined by Professor Primavera, who found them the specific gravity of 1008 (there was still a polyuria of 3 to 4 liters in 24 hours), but complete absence of sugar. 

OBSERVATION LXX. Canon Giovannandrea G., from Ischitella del Gargano, 67 years old, suffering from mild diabetes as a result of eating too much starch, and which seems to have started in September 1873 or some time before: examined by the professor Fede, who noted the presence of 50 gr. of sugar per liter of urine, he was treated with 5 ayril; from with all the rigor that I could demand. In June, he began to eat grass, bran bread, and drink wine, always examining the urine, which remained free of sugar; on June 23, they were again examined by Professor Primavera, who found them the specific gravity of 1008 (there was still a polyuria of 3 to 4 liters in 24 hours), but complete absence of sugar the first days of May, at the second analysis, the urine was free of sugar. At the end of June, Professor Fede again observed in this patient (whom I also saw in consultation with Fede) the complete absence of sugar, although he had returned for more than a month to the moderate use of sugar and starchy foods.

OBSERVATION VIII. Mr. Filoteo V. de Furci (Chieti), 51 years old. He discovered diabetes in April 1871, after a period of indefinite discomfort: a diet almost exclusively starchy. He came to Naples, where, on October 4, Primavera found 60 gr. of sugar per liter of urine, and about 4 liters of urine per day. He was as thin as possible, very weak, impotent, suffering from thirst and hunger. He made a very rigorous cure of 53 days, eating a kilogram of meat a day: then gradually returned, following the rules laid down, to mixed food. On October 8, 1872, he returned to Naples, and the definitive disappearance of glycosuria was noted; MV was stronger than before being diabetic, and free from rheumatism to which he was prone in the past. Here is a patient to whom lactic acid did not give rheumatism, as Foster fears. In September 1874, the healing was maintained complete.

OBSERVATION XIV. - Mr. Rodolfo S., priest of Palma, aged 60, lived only on flour and fruit. In December 1870 he experienced the first symptoms of diabetes, thirst, polyuria, and progressive weight loss; he was very tired of the insomnia. The urine, examined on February 7, 1871, contained 38 gr. of sugar per liter: the patient began my cure on February 8, and already, on the 18th, the urine re-examined was free of sugar; on March 8, the patient began to eat nuts, almonds, limes: the urine remained normal; likewise on August 11, after the patient had returned to the moderate use of bread. He continued to do very well in September 1874. I learned about it from Doctor Carbone de Vico di Palma. 

OBSERVATION XV. Doctor Francesco B., from Frascineto in Calabria, doctor in Castrovillari, 39 years old, ate mainly mealy; he had survived two attacks of cholera, in 1867, and experienced great sorrows: recognized diabetic six months ago, after an analysis of the urine, to which he decided, because he suffered from thirst, hunger, polyuria, impotence and extraordinary weakness. He came to see me on November 5, 1871; his urine, examined by Professor Primavera, weighed 1029 and contained 80 gr. of sugar per liter: subject to my treatment, absolute meat diet and lactic acid, after eight days the glycosuria had disappeared. He left Naples a few months later: there was still no sugar, although he had resumed the use of eggs, green vegetables, fruit and a little flour. He wrote to me on March 5, 1873: he assures me that he is doing perfectly, “although he eats everything." 

OBSERVATION XVI. - Mr. Raffaele C., wigmaker, 26 years old, from Naples. Suffering for two months from great thirst, hunger, polyuria, impotence, weakness and general wasting, with no other appreciable cause than his almost exclusively floury diet, was treated in Paris with sweet and sour drinks which improved gastric catarrh, but the other symptoms worsened. - When I saw him, on November 15, 1871, he had a polyuria of 5 liters per day, the urine had the specific weight of 1043, and contained, according to the analysis of Professor Primavera, 90 grams. of sugar per liter, which made about 450 gr. of sugar lost in twenty hours: he weighed 49kil, 3. 

Submitted to the cure on November 16, his urine was examined on November 23: they were deprived of sugar; all symptoms of diabetes were gone; the patient's weight reached 50 kilograms. From that day on, the improvement continued gradually; 

on January 20, 1872, the patient weighed 52,511.7, 

on January 26 53kil, 1, 

on February 4, 54ki1,8, 

on March 8, 56kil, 3, 

on March 27, 56k1, 6, 

on April 8, 57k1, 1, 

on April 27 57kil, 7, 

April 30 58 kilog., 

May 24 59 kilog. 

He had therefore gained, in six months, 10 kilograms. Today he is doing very well, eats everything and is always fat: seen again by me in the spring of 1874, he appears in an extremely flourishing aspect: he had been happily married for several months. Even today (September 1874), he is doing perfectly well. 

OBSERVATION XVII. - MNN, from Malta, aged 40. This gentleman, whom I saw for the first time in consultation with Dr Jos. B. Sammut, was inclined by temperament to polysarcy; all his life he had abused flour and bonbons, never eating meat. Diabetic for six months, he had already followed my treatment in Malta. He nevertheless came to Naples, with 30 gr. of sugar per liter, with three liters of urine per day, so 90 gr. of sugar within twenty-four hours. Subject to all the rigor of our treatment, their quantity was 1750 с. C., and the sugar had completely disappeared. Thus re-established, he made a journey throughout Europe, consulting all the doctors of some renown, and again made a cure in the waters of Carlsbad and those of Vichy. He sent me from Carlsbad an analysis of his urine and a few lines from Dr. Seegen, from which it appears that the sugar had not reappeared although he had extended his diet: I saw him again in December, fully recovered. He wrote to me again on March 25, 1873 that he was doing completely well. On March 10, 1874, he wrote to me again to tell me that his strength and nutrition were fine. well, but after some overeating, small amounts of sugar reappeared and persisted in the urine, although he would have resumed a diet consisting of meat, green vegetables and gluten bread; he was asking me for advice on this. I told him to resume the cure in all its rigor, for a fairly long time (at least three months), and above all to give up gluten bread, which always contains too much starch for a diabetic; however, the patient has so far not wanted to give it up. 

OBSERVATION XVIII. - Miss Rosina G., from Piedimonte d'Alife, 20 years old, daughter of a phthisic mother: one of her sisters became diabetic before her. She ate almost exclusively starches and sweets. For three years she has suffered from polyuria, hunger, thirst and severe weight loss: for two years she has been recognized as diabetic, thanks to an analysis made by Professor Primavera in 1868; she was subjected to various cures, in particular that of the waters of Casamicciola d'Ischia: all this was of no use. In the spring of 1870, she received the care of Doctors Caso and Paterno who ordered my treatment; she quickly gained in well-being and nutrition; in a fortnight her urine became free of sugar, and although shortly after she was returned to the mixed diet, to the use of bread and fruit, her urine remained free of sugar: I myself have seen the patient in September, in a good state of nutrition, with normal urine, specific weight of 1019, deprived of sugar. Seeing that she was very eager to eat starchy and sweet foods, I allowed her to do so, while warmly recommending never to abuse, as she did in the past, flour and sweets, surrender a second time. It is interesting to note in this case that, before the disappearance of sugar from the urine, the latter contained a very large quantity of crystals of oxalate of lime, which suggested to me the idea that oxalic acid , in certain cases, could, so to speak, substitute for sugar, in the sense that, the combustion of the hydrocarbons being improved in the organism, these begin to burn, but cannot arrive at a perfect oxidation and decomposition into water and carbonic acid, and thus transform into oxalic acid by incomplete combustion. In diabetes, the combustion of sugar is absolutely lacking, it remains in the state of sugar: the conditions of the organism improving, combustion would manage to produce oxalic acid, before get to be complete. Note that the fact of the appearance of a considerable quantity of oxalate of lime, in the urine, after the disappearance of the sugar, was later verified by me several times, and several other times by Professor Primavera. This young girl is doing well so far: on April 18, 1873, I received a letter from her brother, M. Alfonso G., who recommended me another patient of his acquaintance, adding that her sister was in perfect health. well: I saw her again in August 1873, and lately, in September 1874, I learned from her brother that she is in flourishing health. 

OBSERVATION XIX. - The priest C., from Caserta, 38 years old, eating mainly starches, diabetic for 4 years, with 100 gr. of sugar per liter, after having consulted various primary doctors of Naples, and being subjected to various cures by arsenic, strychnine, cod-liver oil, iron, hydrotherapy, etc., was put, in January 1871, the exclusive meat diet, thanks to which the sugar disappeared completely after a rigorous treatment of 40 days. I saw the patient again on September 28, 1871 for a chronic catarrh of the stomach, although he was well fed with normal urine, one to one and a half liters a day, without a trace of sugar, although for a long time. he would have returned to mixed food. I had further direct information on this patient on May 30, 1873, and I knew that he was doing completely well; still today he enjoys perfect health, as I learned in June 1874 from one of his friends, officer in the army. 

OBSERVATION XX.-M. Michele L., from Acireale, has always abused extraordinarily fruits and sweets: it was subjected by Doctor Vigo, of Acireale, to my curative method, and cured perfectly. In August 1872, he himself came to Naples, and wanted to see me to make sure that his health had returned: he brought me the analysis of his urine, made on August 22 by Professor Primavera, which testified the complete absence of sugar. A letter from Doctor Vigo, dated June 4, 1873, once again assures me of the perfect health of this patient.

OBSERVATION XLI. Mr. Félice F., from Cajazzo, 66, owner, almost exclusive amylivore, recognized diabetic for two months, when he presented, in addition to the symptoms of diabetes, signs of mental alienation: he was submitted on April 4 with notable worsening of symptoms for eight months, presented, on April 26, 1872, urine with a specific weight of 1030, and containing 35 gr. of sugar plus half a gram of albumin per liter. The patient undergoing rigorous treatment, his urine was examined again on May 3: it was absolutely free from sugar; the same on May 15 and 30. Since then I have heard of the complete recovery of this patient, although he had long since returned to mixed food. 1872 to the rigorous cure: after four days the sugar had disappeared, and did not reappear, although the patient quickly returned to mixed food. In this case, we never did a quantitative analysis. The patient continued to be free from diabetes until the latest news, which is about four months old. 

OBSERVATION XLII. Doctor Francesco A., doctor of the province of Salerno, 53 years old, great lover of flour, was treated by Professor Primavera, who found, in the first analysis, 105 gr. of sugar per liter: after a week of rigorous treatment accomplished according to my prescriptions, the urine contained only 23 gr. of sugar per liter: the patient admitted that he had continued to eat a little bread: having left it completely, the sugar disappeared entirely, and the patient has enjoyed the best health ever since. 

OBSERVATION XLIII. - Mr. Nicola C., from Pisticci (Basilicata) 25 years old, almost exclusively amylivore, ill for an indefinite time, but suffering for a year from ardor, thirst, sexual debilitation, gastro catarrh -enteric with coprostasis, presented on July 22, 1873, according to the analysis of Professor Primavera, 135 gr. of sugar per liter of urine, and the specific weight of 1042: subjected at this time to the cure; from July 29 the urine was free of sugar; they were still in November 1873, according to what his doctor from Pisticci told me, who wrote to me to ask me for advice about an ischialgia from which this patient was suffering, his urine still remaining absolutely normal: they were also such in the last analysis, made by Professor Primavera on February 21, 1874, although the subject had for some time returned to mixed feeding, and even to mealy foods. I saw this patient again on June 24, 1874; his urine, again analyzed by the same professor, was absolutely free of sugar, although he ate during that time, flour in moderate quantities. 

OBSERVATION XLIV. - Baron Rodolfo A., from Naples, 34, has always made great use of starches; for only two years, he suffers from a great thirst with polyuria, his general condition progressively worsens, as well as weakness and thinness; this is why in October 1872, he had his urine examined; there was evidence of the presence of sugar. What frightened the patient the most, threatening of the lens; the various cures to which he was subjected had only a mediocre success, because he came to see me on March 30, 1873, with 100 gr. of sugar per liter of urine, according to the analysis of Professor Primavera, and the specific weight of 1040. Submitted to my treatment in all its rigor, from April 6 his urine was free of sugar, weighed 1020 and on the 10th April, 1015. Since that time he has been in perfect health. Professor Primavera has it. core examined urine on June 19; they were completely free of sugar, although the patient had, for some time now, neglected the rigorous treatment. He went well, until the last news received. 

OBSERVATION XLV. - Mr. Gennaro M., owner in Santa Maria di Capua Vetere, aged 40; he greatly abused flour and fruit, and also sweet dishes; for some time he had felt an ardor of the mouth, with thirst and polyuria, and in June 1873 he presented all the other symptoms of diabetes, sexual weakness, emaciation, frustration. In October, furunculosis was added to it, and this, by its obs- tession, decided the attending physician, Dr. of 110 gr. of sugar per liter, the specific weight of 1037, a polyuria of 5 to 6 liters per day (which makes 5 to 600 gr. of sugar per 24 hours), and the almost disappearance of urates. Submitted to my treatment in all its rigor, the urine no longer contained, after three days, only 50 gr. of sugar, and, after eight days as 25: after eight more days, sixteen from the start of treatment, the sugar had dropped to 4 gr., and in the fourth week to zero, with abundance of uric acid and urates. - I saw this patient again on December 16; I found him in perfect health, however he complained of a more marked muscular weakness even than before, although he had grown a lot in appearance: later he regained all his strength. - Doctor Fossataro also told me that this patient, when he took a lot of baking soda with lactic acid, had limpid urine with a slight sediment of urates after cooling (note that it was winter) , while taking little or no bicarbonates, it frequently emitted free uric sands. February 3, 1874, almonds, dairy, coffee and wine; his urine was always free of sugar: it remained as it was after the patient had resumed the use of bread and pastries in moderate doses. As to the causes, it should be noted that this patient has always abused farinaceous plants a lot: the occasional causes of diabetes, admitted by the patient, would have been repeated exposure to damp cold, and fear: but by examining the things up close, we see that these acted when the diabetes had started a long time ago: the shock of fear only drew more attention to the patient's state of health; At the most, we can admit after this moral emotion, an aggravation of the disease. - I saw the patient again in July 1874, he was perfectly well (and it was after four months of mixed feeding), flourishing in appearance and ruby ​​in color, with absolutely normal urine (according to Professor Primavera's analysis); it is therefore legitimate to consider this gentleman as perfectly cured. I had further news in September 1874: he was doing the best in the world. 

OBSERVATION XLVI. Canon Vincenzo C., 68 years old, from San Severino Lucano, a man endowed with a strong constitution, and a great hunter, feeding mainly on starch, suffered from renal colic, due to uric stones, such as attests to the report of his doctor, Doctor Santagata. For some time now he had suffered from great thirst with exaggerated appetite, and urinated much more profusely than usual. The urine examined on July 10, 1873, discovered sugar in a dose of 30 gr. per liter, showed the specific weight of 1025, with about 3 liters of urine per day; then subjected to the rigorous cure, from July 21 the urine was free of sugar; since then he has always been doing well. In January 1874 I had more good news from him, and yet he had returned to mixed feeding. 

OBSERVATION XLVII. - M. Filippo F., aged 34, silversmith in Naples, from a very healthy family, and himself of good health and a robust constitution, gradually experienced an increase in the quantity of urine, up to 16 or 20 urinations per day; at the same time, he felt a dry mouth, and a burning stomach. His urine having been examined by Professor Primavera, according to the advice of 100 gr. of sugar per liter: they were abundant up to 6 or 8 liters per day, which made from 6 to 800 gr. of sugar in 24 hours. The patient could absolutely indicate no cause for his illness; he had experienced no sorrow, no trauma, no morbid history: let us note, however, that he ate a lot of starchy foods, and extraordinarily abused sweet jellies. Submitted to my cure, and following it in all its rigor, the urine had, on September 15th, the specific weight of 1021, its quantity was reduced to a liter or a liter and a half, and the sugar had completely disappeared. Another analysis of December 11 gave the same result, but by the fact of Oliguria the specific gravity was 1027. He then began to eat pastures, milk and dairy products, cheese, olives, salads: he drank wine: later he tried a little piece of bread. He continued to be well, having returned to a moderate mixed diet, although he experienced very great sorrow in February 1874, owing to an illness of his father, who died on February 18, and that he was very afraid of "a recurrence" as a result of this great sorrow. At this time his urine was analyzed, for he was deeply struck; however on March 3 they were completely free of sugar, rare in their quantity (800 gr. in 24 hours) and specifically made 1026: they also contained very-numerous crystals of oxalate of lime; thus the oxa-. luria was substituted in this case, as in several others, for the sweet biabetes. This patient still enjoys today hui (September 1874) in the best health. 

OBSERVATION XLVIII.-MTR, of Roccasecca, 40 years old, amylivorous by habit, suffered for about two months, according to the report of his doctor, Doctor Giovinazzi, from an intense thirst with polyuria of 7 to 8 liters per 24 hours, poor hunger, great emaciation and weakness in walking. The chemical examination showed the presence of sugar, which was however not measured. Subjected on April 23, 1873 to the rigorous cure, the sugar, after four days, was reduced to traces: on August 29, urine was sent to Professor Primavera, and the latter, not knowing how it was previously recognized the existence of diabetes, believed in an erroneous diagnosis, so absolute was the absence of any trace of sugar. MTR continued to do well until the last news received, although it has returned to a carefully mixed feed.

OBSERVATION XLIX. The dream. M. A Camilleri, 62 years old, from Nadur del Gozo (Malta), lived to live on mealy and bonbons, a case observed in January 1873, by Dr. P. Sammut, of Gozo, and already published by him. In the grip of progressive weight loss and digestive disturbances for a year, when it was first observed, with a urine emission of 6 to 7 liters per 24 hours, and considerable thirst; these symptoms made Doctor P. Sammut suspect diabetes; urine analysis, with a specific gravity of 1048, confirmed this diagnosis. The mala was so weak at this time that he could not extinguish a candle within eight inches. Subject to my treatment, it improved rapidly: in a few days, the specific weight fell to 1032, after another eight days, to 1026. It was discovered that he secretly ate the sixth part of a biscuit, and this was deleted again: after another twelve days, the urine was completely free of sugar, according to Trommer's test, and weighed 1012 Dr P. Sammut notes that this is the first case of diabetes cured in the island of Gozo, where in the past all diabetics would die without remission (as everywhere else), from the sad consequences of this disease. 

OBSERVATION L. Doctor Salvatore Grima, 32 years old, from Casal Kala del Gozo (Malta), courageous amylivore, recognized as diabetic on March 29, 1873, by doctor P. Sammut, with 8 liters per day of urine, a specific weight of 1045: he had lost extraordinary weight. Subject to my treatment, his condition improved in a few days; from April 12, 1873, the urine was completely free of sugar, and all diabetic symptoms were gone; since then he has been doing well. This observation has already been published by Dr. P. Sammut.

OBSERVATION LXXI. - Mr. Cesare de S., 54 years old, owner in Catanzaro. Suffering from ardor in the mouth and from polyuria since 1871, took a treatment which was prescribed to him by Professor Villanova, and which consisted in the menu of Bouchardat, with iron and strychnine, and later of l 'Lactic acid; the morbid symptoms diminished following this long-followed treatment; on July 19, 1873, he still offered 30 gr. of sugar per liter of urine, the polyuria was 4 to 5 liters per day and the specific weight 1036. This patient affirmed to have always singularly abused mealy and fruits, but was not reached by diabetes until after the grief he had suffered. caused the death of his wife. He affirms, moreover, with all possible precision, that he did not begin to feel better, to gain in strength and in plumpness, until after having begun the use of lactic acid: he assures us that , with him, the absolute meat diet rather diminished general strength. After he had been subjected to my rigorous cure (in July 1873), the urine quickly got rid of the sugar, and on April 15, 1874, long after the patient had returned to the use of bread and pasta (albeit with a moderation very different from the abuse of the past), the urine had the specific gravity of 1.023, and the sugar was absolutely lacking in it, as Professor Primavera found; their quantity was perfectly normal. I had further excellent news from this patient later. 

OBSERVATION LXXII. - Mr. Guiseppe Ti ..., 46 years old, notary in S. Elia Pianise (province of Molise), client of Doctor Colaviti, consulted me in May 1872; he had recent diabetes, weighing 50 to 60 g. of sugar per liter, and a polyuria of 3 to 4 liters per day. Subjected to my rigorous cure, after four days the urine was free of sugar; he returned, after having strictly followed the meat diet for two months, to a moderately mixed diet, and remained perfectly cured. - In this case, the diabetes had developed without any cause known to the patient, except experienced grief before having diabetes. But he experienced severe colds, and severe grief about two years after being cured of diabetes, and as, as a result, he experienced pain in his lower back and increasing general weakness, with swelling. legs and strong attacks of dyspnea especially during the night, he was afraid of a return of diabetes, and had his urine examined by Professor Primavera on September 18, 1874. The urine was found to be perfectly free from sugar, it weighed 1014, and were loaded with albumin (10 gr. per liter). From this it follows that a man cured of diabetes does not take it again, even after serious grief, provided that he does not abuse hydrocarbons again, even if, by other morbid causes, he has acquired , at that time, another disease. The following case cannot so far be given for a definitive cure; but in any case it deserves to be cited after the cured cases, because a cure (at least transitory) has been obtained in very difficult circumstances, and because, if the patient were prudent and wise, one could even to regard as assured a lasting cure. 

OBSERVATION LXXIII. · Mr. Odoardo G., from Bologna, 22 years old, studying veterinary medicine. He says he suffered from polyarthritis for six months, during his teenage years, and after that he felt a stronger heartbeat. He had measles, smallpox, and intermittent fever. He abused Venus, tobacco and wine. He was very fond of starchy foods, and particularly sweets; of these especially he greatly abused. In September 1873, during the course of a slow disease of which he does not know how to specify the point of departure, he noticed that he was urinating enormously, that he experienced an extraordinary thirst and a great appetite, while he was 'significantly weakened and slimmed down. The analysis then showed the presence in the urine of a large amount of sugar. But already, a year and a half before, he was having fun, he himself said more to play than to calm his thirst, to drink 14 or 15 large glasses of gaseous sugar water; So it seems that the thirst was already increased. It should be noted, however, that four months before realizing his current illness, in about May, he fell while climbing a staircase and violently hit his occipital region: to believe that the disease had started slowly much earlier, especially since the patient, in the month of September, when we noticed the presence of sugar in great proportion in the urine, was already notably weakened and emaciated. On October 3, 1873, he entered one of the most important clinics in Italy. Put on the rigorous diet of the meat diet, the sugar completely disappeared after six days; but after various attempts to return to the ordinary diet, and especially several deviations from his diet, the sugar no longer completely disappeared. He left this clinic for good on January 9: returning to his old habits, he noticed an aggravation in all the symptoms, thirst, general weakness, manly impotence, weight loss. The maximum urine output in 24 hours during his stay in this clinic was, according to him, six liters. Having come to Naples, he was received at our clinic on January 19, 1874, exhibiting extraordinary weight loss, general weakness, virile impotence. In the somewhat asymmetrical thorax, there was a slight difference in the pitch of the sound on percussion, and in the prolongation of the expiratory sound. On the heart, a little enlarged, a very slight pericardial murmur: the spleen is enlarged, the liver is not accessible to touch. No other symptoms, no pain in the chest or the rest of the body, no cough, no feeling of worry; but hunger, thirst, and a lot of sugar in the urine. On January 20, he emitted 3 liters, 460 of urine which contained 100 g. of sugar per liter, i.e. 340 gr. per day; the next day he made 5 liters, 760 with 570 gr. of sugar in 24 hours. On January 23, he was put into treatment. From the first day, the urine was 1440 cc in quantity, with 60 gr. of sugar per liter, or 86 gr., 4 per day. The following days the quantity of urine remained normal, on average from 1 to 2 liters, with a high specific weight, between 1030 and 1034, while the quantity of sugar oscillated between 30 and 35 per thousand, between 40 and 70 gr. per 24 hours. On February 4, the first absolute fast of 24 hours was ordered, during which the sugar disappeared entirely: but it reappeared at a dose of 30 gr. per liter, as soon as the patient ate, even meat only. So they reduced her ration, and gave her a soft drink made with bicarbonate of soda of lactic acid, and 1/2 gr. Of potassium carbonate, in water: after this treatment with a reduction of half in the quantity of meat), the sugar fell on February 12 and 13 to the proportion from 1 to 2 gr. per liter. Some thoughtlessness committed from time to time brought it back to 20 per 1000. As the ration increased, the sugar returned to 30 gr. per liter, but a new fast on February 23 made it disappear again completely: the return to the ordinary ration of meat again made traces of sugar reappear, which increased day by day up to 5, 10 and 15 gr .; note that the highest figure was reached only when the patient smoked in secret; when he did not smoke, the sugar decreased, and stood between 4 and 5 gr. per 1000. These small quantities disappeared definitively on March 19, after the administration of pure potassium carbonate dissolved in water, for four days, at a dose of 4 gr. in 24 hours. Since then, the sugar remained absent, the quantity of urine was normal, and their specific weight oscillated between 1026 and 1014. Note that this patient, on entering the Clinic, weighed naked (with his shirt and underpants, and he was is always weighed with the same clothes): 

January 19, 1874 ....... kil. 49,500 he first continued to lose weight and weighed, - January 21. the 24th the 29th February 2 ... the 4 kil. 48,900 48,600 48,300 48,000 47,500 ”after which it began to resume on February 7th. the 11 the 12 the 13 kil. 48,200 48,600 48,800 49,200 to decrease and descend on February 15 to ........ kil. 48,500 and return on February 20 to ..... . kil. 48,700 and go back down following diarrhea on February 22 to .... kil. 47,200 The weight rose quickly, so much so that it reached on February 23 ... 27 kilos. 47,800 48,800 and remained such for some time, with insignificant oscillations, after a purgation, it descended on March 8 to ...... kil. 47,500 oscillations which are largely understood by the fact that the intestine is more or less full. After the complete disappearance of sugar, the weight of the body gradually increased: we found >>> >> >> on March 19th. April 24 28 April 11. the 13th the 17th the 19th the 27th May 1st. the 5 the 6 the 22 kil. 48,200 48,700 49,300 49,600 49,800 50,100 50,700 51,000 51,700 51,900 52,700 53,100 >>) »» So that since February 22, the day of minimum weight, he had gained in three months of treatment, 5 kil. 900 gr. The temperature always oscillated between 36 and 37 ° C., the pulsations which initially were between 50 and 60, were maintained later between 64 and 72, sometimes going up to 80: the breaths were always between 20 and 24 Minute. 

On May 20, this patient, who as a student had, since April, obtained permission to go out every day, suddenly presented sugar in the urine, 8 gr. per liter and per day. Although the patient affirmed that he had not eaten outside of the clinic, I learned that for several days he had been taking rum, which in Naples always contains a lot of sugar: we are willing to believe that he hadn't eaten anything else. In addition, he was struck with a stone in the chest in the street, and so violent that he was thrown to the ground unconscious, felt pains in the right subclavicular region, a region which had been directly struck: he also had a little fever with sonorous groans with small bubbles. 

On May 21, the sugar had reached 10 gr. per liter, from the 22nd it dropped to 4g., on the 23rd and 24th it was maintained at 3g. to disappear on the 25th and remain absent until the 30th, the day when the patient escaped our supervision For more than 15 days this patient, according to his own confession, made when I presented him to my audience to take leave, was eating fresh beans (!), cherries, other fruits, and drank wine. Despite this the glycosuria had ceased. She had not yet reappeared at the end of July, the patient assured me in a letter, although for 12 days he had eaten not only green vegetables, but also milk, cheese and fruits (among which the sweeter ones, like pears, plums, etc.) and half-flour, beans , fresh peas, and eat them up to two kilograms per day (!). The circumscribed pneumonia had somewhat reduced the patient's weight: from 53kil, 1, maximum weight on May 22, it had gradually dropped to 51kil, 4, on May 28, to rise to 53kil, 2, on June 23. 

In a patient as advanced as this one, I would not have allowed the return to the mixed diet, or even to the Bouchardat menu, before at least six months of rigorous treatment, after the disappearance of the sugar. - If I report this observation among the cases of cure and the last, I must make this reservation that I am in doubt about it: the cure is not final: it is too short a time since he returned to the use of milk and fruit, etc., and then he abuses them again. In any case, this patient has demonstrated that even very advanced diabetes can be cured when the cure is carried out with all its rigor (1). (1) As I correct the proofs, I receive a final note about this patient. In the second half of August, after further abuse of fruit and wine, this patient again noticed sugar in his urine, and by an approximate calculation evaluated it at 5 or 10 grams per liter. He suspended the use of fruit for a single day, and the sugar disappeared. 

At the beginning of October, I received a letter from the father who told me: "For a month the sugar had reappeared following a new abuse of fruit and even bread: we knew afterwards that he had also abused liquors and pills containing vomit nut: he took eight in a single day, whereas he should only take two or three. This gave him a sharp intestinal inflammation, from which he died on September 28 ”. So he died of intestinal inflammation! (Author's note.)

I do not wish to speak here of the patients whom I am treating at present, although in all these cases there are a great number in the process of perfect recovery, and several patients have already returned for some time to the use of carbohydrates: but enough time has not yet elapsed, and I cannot regard them as fully healed. In addition, there are many cases of diabetes cured by my method, by other doctors: so that today we can count diabetes among the most curable diseases. To pretend that a man cured of diabetes could not get it back, even under the conditions in which he contracted it the first time, would be nonsense: just like to claim that one can no longer contract pneumonia, acute catarrh or rheumatism, when you are cured of a first attack, or several. Just as it would be unwise to claim that it is the same disease which recurs after several years, it would be incorrect to maintain that a man, cured of diabetes for one, two or three years and eating everything, experiences a "Relapse" if they contract the disease again after further abuse of mealy or sweets, and under the influence of debilitating conditions. Should it therefore be that the treatment procured future immunity, and that the patient had acquired impunity with regard to the abuse of starchy foods and fruits? It would really be asking too much of a treatment to require such immunity before declaring it effective. Quinine and mercury are not required as much as they are said to be specific, and which do not always even prevent recurrence of morbid manifestations. I cannot cite here the names of all those of my colleagues from Italy or abroad who have obtained success with my treatment: but it would be necessary to add to the 73 cases published above, 52 other cases cured by others than by me, which would make 125 successes obtained in 4 years (1), a figure not to be despised in (1) I asked Professor Primavera for notes on the cases of diabetes treated by him alone . He replied to me by the following letter, which I publish without comment: 

Naples, January 25, 1874. 

Very honored Professor Cantani, 

You ask me for notes on diabetics which you have not seen, but which I have analyzed urine and disease monitoring. Strictly, I don't and which do a disease previously regarded as incurable. Moreover, this cure has become popular in our southern provinces, where everyone orders it, even pharmacists, priests and former patients. Success is assured provided that the treatment is not started too late, provided that it is followed with all the necessary rigor and for a sufficient time. The high frequency of diabetes in these countries means that its beginnings do not escape attention as easily as it once did, and still happens in countries where diabetes is rarer, and therefore is often recognized too late, if the patient does not watch himself, or if he comes across a doctor who does not pay attention then say the exact number, but I can assure that they are roughly twenty in number: some from outside were treated according to your method by foreign doctors, others treated in the same way by Neapolitan doctors, some finally absolutely wanted to be treated by me, always according to your method, henceforth known to all. 

The first piece of information I must give you is this: I have never seen a single one of these patients not being cured, and if four of them seemed to resist the treatment, it is because they were not following it, not with enough rigor; but warned by me, they did it, and also came to a complete recovery. This fact is certainly very consoling, I do not explain it by the practice of other doctors who have also administered to their patient several therapeutic agents unrelated to your medication, such as a decoction of quina, strychnine, opium and the like; but, on reflection, let me explain it to myself because the diabetics of the civilian clientele, that is to say rich or at least well-off, do not allow their disease to age: on the contrary, the poor diabetics who resort to hospitals when they really cannot take it any longer, must necessarily provide a contingent of incomplete healings. My second piece of information, which I guarantee to be correct, relates to this fact: patients who do not strictly follow the meat diet often emit in their urine, along with a little sugar, lime oxalate; so that the presence of this salt is very useful for me to deny those who claim to adhere strictly to your treatment, and transgress it more or less, by eating a little bread or fruit (often out of ignorance). 

As for the return of diabetes, I have observed several cases of it after eight months and more, up to two years; but I have always seen the sick recovering again with the same treatment. So much so that it can be said, with great probability, if not complete certainty, that any diabetic, once cured by your method, could secure lifelong cure, if he had the patience to repeat the rigorous treatment for two months every semester, and this for a number of years. If I were diabetic this is how I would act, with the firm conviction that I would never die from it. Finally I noted in all these patients, as a constant cause, the usual abuse of flour (bread, pasta in general): only once was this abuse lacking, but there was, on the other hand, abuse of cane sugar (sweets, sorbets, jellies, sweet coffee, etc.). 

G. PRIMAVERA.

OBSERVATION LI. MRG, 47 years old, from Terra di Lavoro, a habitual amylivore, with an adipose constitution, himself noticed polyuria in 1871, and a few months later progress in weight loss and weakness: for that, and for unquenchable thirst, with continual dryness and ar- teness of the mouth, and above all for sexual debilitation, he had recourse to his doctor, the distinguished doctor Leonardo Bian- (1) In Barth, Gazzetta di medicina e di scienze naturali, di Malta, di GAVINO Gulía, Anno II, Nov, 15 and 16. Malta 22 luglio 1873. (2) In Barth, loc. cit. and all the diabetic symptoms were gone; since then he has been doing well. This observation has already been published by Dr. P. Sammut (2). chi. In April 1873 the urine, about 7 liters per day, had the specific weight of 1035, with 130 gr. of sugar per liter, about 900 gr. per day. After a cure almost exclusively meat, with tolerance of a few berberages, a little butter, a little red wine, which was prescribed to him by Doctor Bianchi, the patient improved extraordinarily quickly, so that ' after eight days, he emitted only 2 liters of urine, with 70 g. of sugar per liter, 140 gr. about sugar per day; after five more days, he emitted only a liter and a half of urine, with 49 g. of sugar per liter. Consulted on May 4, I insisted that the cure became rigorous, I prohibited butter, vegetables and wine, granted by the transaction of Doctor Bianchi: after fifteen days, the sugar completely disappeared from the urine, the volume of which fell to 700 cc, the patient regained his strength and has been doing well until this day (September 1874), where I have received news from him: for more than a year, he returned to mixed feeding. 

OBSERVATION LII. - M. Guiseppe Durini, 47 years old, from Bolognana (Chieti) (1) very fat in 1866, usually eating large quantities of flour, fruits and sweets, began little by little, without any known cause, and especially without having experienced any moral emotion, to lose weight; in the last seven months he became extraordinarily emaciated: at first, this symptom was attributed to diarrhea which had occurred in the meantime. Finally he showed himself to Doctor Colombo de Nicola, who noticed polyphagia, polyuria, polydipsia, vision impairment and impotence, suspected diabetes and confirmed this suspicion by urine analysis. On January 2, 1874, the patient emitted 5 liters of urine in twenty-four hours, with 65 gr. of sugar per liter, which makes 325 gr. of sugar per day; after eight days of rigorous treatment, Primavera observed the complete disappearance of sugar. The patient continued to be perfectly well; he returned to see me on April 7, 1874, comforted, flourishing in appearance, perfectly healthy, ruddy in color, with greatly improved eyesight. I allowed her the pastures, the wine, the coffee (without sugar), some unsweetened fruits. I saw him again in the best state of health on May 17, 1874: his urine was completely free of sugar, weighed 1022, because it was rich in urea by the fact of (1) He himself wanted to be named here, meat diet; I then allowed him the starchy foods: at the last I heard he was still doing very well, and feeling stronger than ever. 

OBSERVATION LIII. - Doctor G., a very distinguished doctor and director of a hospital in one of the most important towns of Campania, about 50 years old, of fat constitution, lover of starches, contracted diabetes mellitus in 1871, presenting the usual symptoms, with weight loss and considerable weakness. Having learned of the happy results that I had since obtained at my Clinic, which a young student of his parents attended, he submitted to my treatment, and followed it with great rigor. He recovered completely, and used a mixed diet for a long time: today he has gained weight again, he is flourishing in health, and a few weeks ago (August 1874), I saw him in consultation for one of his patients (1). 

OBSERVATION LIV. Doctor Pasquale M., distinguished doctor from Salerno, about 60 years old, of normal constitution, extremely amylivorous, suffering from diabetes for two years, with all the ordinary symptoms; so emaciated and weakened that it was difficult for him to continue his visits, and a little frightened also by the sight of the progress of the diabetes in the dean and the most renowned of the doctors of Salerno, Doctor Centola (who never did the treatment of rigorous meat diet, wasting his time taking arsenic, strychnine, and following the Bouchardat diet), Doctor PM submitted to my treatment, followed it rigorously, and recovered completely; therefore, fully recovered in possession of his strength and with normal urine, although he had returned to mixed food for about a year, I saw him again a few months ago (in March 1874 ), in a consultation in Salerno, which he attended as an attending physician. 

OBSERVATION LV. - Dr. Guiseppe B., from Randazzo, who usually ate a lot of starchy foods, ill, according to what he wrote to me, for three and a half years, is now fully recovered: his urine are normal in specific weight, free from sugar, although, for several months, (1) Special considerations, and the wishes of this distinguished colleague himself, require me to suppress the other details: it is the same for the following cases. he returned to a mixed diet about a year ago. I saw him again a few months ago (in March 1874), in a consultation in Salerno, which he attended as an attending physician, he returned to mixed feeding. On February 26, 1874, this distinguished colleague wrote to me that having interrupted the rigorous treatment too early, he relapsed four times, so much so that he began to regard my treatment as a palliative which suppressed, but did not cure diabetes; but after having followed it for a sufficient time, he was able to return to a mixed diet without seeing the sugar reappear in the urine: he then reconsidered his previous opinion. 

OBSERVATION LVI. MF Saverio M., from Borgia (Cantanzaro), 53 years old. At the age of 40 he experienced, as a result of serious sorrows, sufferings in his stomach and intestines, with diarrhea: but he recovered completely, got married at 14, had children and did well until the age of 49. At this age, and with no known cause (apart from the daily abuse of mealy seeds), he began to present the first symptoms of diabetes, which he recognized in him a year later by Doctor Cirillo, who prescribed him a treatment which was followed for two and a half months , and which consisted of a diet composed mainly of meat, eggs and milk, with limitation for the use of flour, all accompanied by a prescription of cinchona, strychnine, rhubarb and baking soda. A great improvement followed, but hardly the cure ceased, the patient relapsed and more seriously than the first time. So Doctor Cirillo prescribed a more rigorous treatment, ours, forbidding the use of fruits, milk, vegetables and flour, and adding lactic acid to the previous drugs. The patient got better again, but as he was not sufficiently rigorous in his diet, he presented on January 27, 1874, when I was consulted, 30 gr. of sugar per liter, with a polyuria of 2 to 3 liters per day, and the specific weight of 1023. Subject to my rigorous treatment, the urine, examined on February 15 by Professor Primavera, had the specific weight of 1015 and was completely free of sugar; they were still similar on April 27, 1874. The patient continues to be well, although he has resumed the moderate use of flour. 

OBSERVATION LVII. - Mr. Giacamo F., 33 years old, from Tunis (Africa), client of Doctor Quintilio Mugnaini. He had two brothers who died of diabetes, the second from phthisis after consulting the best doctors in the largest cities in Italy, the rigor of my cure. The patient himself, as his brothers had done, ate almost exclusively on flour and very fond of sweets; he never had moral emotions. In September 1873, he noticed that he had a slight polyuria, that he got up three times at night to urinate, while before that he always slept through the night. The example of his brothers made him seek advice from his doctor, Doctor Quintilio Mugnaini, who analyzed the urine with the help of the pharmacist Sinigaglia, and finding them sweet, diagnosed diabetes, and submitted the patient to my cure. After three days, the urine was free of sugar; after ten days, he ate a little bread, and the urine picked up a little sugar, but with a much less clear reaction than the first time: this sugar disappeared again after a more careful treatment of two months. After forty-five days the patient returned to a varied diet, for he was feeling quite well, and his nutrition was good. On February 25, 1874, he came to Naples, and wanted to consult me: his urine, examined by Professor Primavera, was free of sugar. This case is very interesting because it demonstrates, not only that diabetes is often a family disease, thus affirming its constitutional character, but also, by the sad antecedents of the two brothers, neither long enough nor rigorously enough. treated, that the third brother followed the same route and succumbed, if he had not been saved by coming in time to be treated and to follow the treatment exactly. He also demonstrates that there are not two kinds of diabetes, one curable, the other incurable: curability depends on the degree reached by the disease, on the period at which the disease is recognized, and the patient subjected to rigorous treatment. 

OBSERVATION LVIII. Mr. Carlo de S., 44 years old, military employee on the island of San Stefano. As a result of a great abuse of starchy substances, for he seldom ate meat, and without any other known cause, he suffered from diabetes; for some time he kept his illness concealed, although he suffered from polyuria, with thirst, impotence, great emaciation and extreme weakness. In June 1873, the presence of sugar was found in the urine, and he followed a treatment, but not with sufficient rigor: he ate almost exclusively meat, bis. The sugar gradually disappeared from the urine, and the treatment continued for five months. The urine remained free of sugar, and the patient recovered, assumed a flourishing appearance, and felt robust and strong. Having returned then to abuse flour and to abandon the meat almost completely, after a month we found sugar in the urine, but in small quantities. Professor Primavera, on March 1, 1874, found only 5 gr. of sugar per liter in urine emitted on an empty stomach at 11 am; the urine presented this interesting thing, that it was rare in the morning, but very abundant after the meal, during which he consumed so much flour. The urine, after the meal, contained up to 50 gr. of sugar per thousand. It is a kind of intermittent diabetes depend on the diet, such as starting diabetes. On March 23 began my rigorous cure, and shortly after the urine was completely free of sugar. In June 1874 he was still doing perfectly well, although he returned to a mixed diet after only a month of rigorous treatment. 

OBSERVATION LIX. Mr. Nicolangelo S., 53 years old, from Forino (Avellino). Diabetic since August 1873, by abuse of flour and without other known cause, he also presented a symptom of beginning diabetes, that of the intermittence of diabetic phenomena (polyuria, thirst and sugar in the urine, only after meals, usually rich in starch; in the morning urine is normal and completely free of sugar). - Come to Naples to consult me, he presented me, on January 3, 1874, urine emitted after meals, and whose specific weight was 1034, with 60 gr. of sugar per liter: he immediately submitted to my rigorous cure; from January 22 the urine was sugar free, and weighed 1018: the same on February 23. The severe cure was only continued for a short time: nevertheless, according to the news received, he is still doing perfectly today, although he makes moderate use of the mixed diet. 

OBSERVATION LX. Mr. Aniello S., lawyer, 47 years old, from Carbonara de Nola. Recognized diabetic by Doctor Mele in Ayril 1872; after 2 days of rigorous treatment, his urine no longer contained sugar; he continued thus for a month only, and then was very well, although he ate everything; however relying too much on his regained health, then he abused for a long time flour, sweets and wine, so that again contained sugar; however, the patient was subjectively well. He resumed the cure in January 1873, for 40 days; his urine got rid of the sugar, and he was well, although he ate everything. But in the carnival of 1874, returning to the abuse of sweets, he began to urinate more, and felt his virile power go away: the urine examined contained sugar: here is therefore a relapse after 13 months of well- be and mixed diet, brought about by the abuse of sugary foods. On March 7, 1874, the urine examined by Professor Primavera showed the weight of 1035 with 70 gr. of sugar per liter: but there was no polyuria yet. The cure resumed, the sugar soon disappeared, and the patient regained virile power. - He continues to do well, to what Dr Mele assured me in September 1874. - What is remarkable in this case is that it shows that an individual, who has once contracted diabetes, should not never again abuse the sweets, which are even more perilous and harmful than the mealy ones themselves. This case also teaches that there is no need for trauma or moral suffering to reproduce diabetes: the abuse of hydrocarbons is enough.

My 73 cases of recovery can be divided, from the point of view of a rigorous recovery statistic, into 8 categories: 

1. Category. - Cases cured and remained in good health to this day (September 1874): these are numbers I, V, VI, VIII, XII, XIV, XV, XVI, XVIII, XIX, XXII, XXIII, XXXII, XXXVII, XXXIX , XLII, XLIII, XLV, XLVII, LI, LII, LIII, LIV, LV, LXII, LXIII, LXIV, LXVI, LXVII, LXXII. In all thirty cases. 

2. Category.- Case of diabetes cured, dead, more than a year after returning to mixed food, due to any recurrent disease, without the sugar ever reappearing in the urine. These are numbers IX, X and XI. Three cases. 

3. Category. - Cases of diabetes cured and remained notoriously healthy for a very long time, until the latest news, but not seen for some time. In this category we must classify nos III, VII, XX, XXI, XXIV, XXV, XXVI, XXVIII, XXXI, XXXIII, XXXV, XXXVIII, XL, XLI, XLIV, XLVI, XLVIII, XLIX, L, LVI, LVII, LVIII, LIX, LXI, LXXI. Or twenty-five cases. 

4. Category. - Case of diabetes cured, enough to be able to return to a mixed diet, but having fallen ill again, following a new abuse of flour, pasta and sweets, and cured again by treatment. Nos. IV, XIII, XVII, XXVII, XXX, XXXVI, LX. Or seven cases. 

5. Category. - Case of diabetes cured recently, being able to use moderately flour, fruits and even sweets, without the sugar reappearing in the urine: these are nos LXV, LXVIII, LXIX, LXX. In all four cases. 

6. Category. - Cases of diabetes that have remained intermittent at long intervals, when the patient abuses sweets: Let there be two cases to this point numbers XXIX, XXXIV. The transient intermittence of diabetes was also observed in case XXX after recovery obtained: but here it was followed by the complete return of diabetes with its most terrible phenomena. There is still intermittence in the LVIII case, when the patient, recovery obtained, returns to the use of starchy foods. Finally, it was noted again in the LIX case, and there it came after abuse of the hay-fed, when the patient had taken a meal too loaded with hydrocarbons; it is cured by a return to treatment. In the LVIII and LIX cases, diabetic intermittence was observed with regular intervals, and with a very exact daily type: melituria then depended solely on meals; once the sugar that the organic forces had not been able to transform, it disappeared once again: this was a form of diabetes beginning in which the daily return of meals at the same times leads to a regular return of sugar with the daily type. (Author's note.)

7. Category. Case of diabetes cured, but became ill again a long time later, having returned to an almost exclusively starchy diet, and died as a result of diabetes, for not having resumed treatment. Here we must note case II. So there is only one. 

8. Category. - Case cured for a short time and therefore not yet assured of recovery, then became slightly ill again following a premature abuse of prohibited foods, and finally died, not by the fact of diabetes, but by an intercurrent disease. Here we must cite the case LXXIII. So there is only one.

Nineteenth century diets for diabetes were just as varied as those of the twentieth century. The Italian physician Cantani, who had a large and lucrative private practice, enforced starvation by locking his patients in their rooms and feeding them on lean meat, fat and dilute alcohol [5].

Cantani treated his diabetic patients by eliminating carbohydrates and prescribing an exclusive meat diet.[3] He believed that stopping glycosuria was the major method of controlling diabetes.[4] He allowed his patients as many calories as they could tolerate without glycosuria. Later he limited daily food intake to about one pound of cooked meat. If glucosuria persisted, he fasted his patients.[5] The exclusive meat diet would continue for several months but if urine was not free of sugar it would extend to six or nine months.[3] To control glycosuria, Cantani would enforce his diet restrictions. He would often lock his patients in a room, so they adhered to the strict diet.[6] He performed microscopic studies on the organs from thousands of cases and observed that atrophy and fatty changes were more frequently found in the pancreas of diabetic patients than of non-diabetics.[7][8]

https://en.wikipedia.org/wiki/Arnaldo_Cantani

Professor Arnoldo Cantani, one of the most brilliant and distinguished of Italian physicians, died on May 1st, aged fifty-seven. His death was caused by Bright's disease, a malady concerning which he had written much. He was at the time of his death Professor of Clinical Medicine in the University of Naples. While at Naples he wrote monographs upon the “ Diseases of Metabolism,” “ Progressive Atrophy of the Skin," “ Lathyrismus," “ Enteroklysma,” “ Different Morbid Aspects of Individual Infective Disease,” to say nothing of a vast number of occasional monographs and notes on his favorite themes of fever, inflammation, and infection. “ The predominant note in Cantani’s character," writes a Neapolitan correspondent of The Lancet, “ was serenity. No one possessed a calmer, more perfectly balanced judgment; no one was further removed from all that savors of flattery or assentation. He had in a rare degree what professional men call the ‘ clinical eye ’ —a possession all the more remarkable in that he did not lay himself out so much for consultant practice as for investigation in the pathological laboratory. The honors, of which he had more than his share, came to him unsought, and he never was heard or seen to set store by them. Called in 1889 to the Senate of the kingdom, his health, never robust, kept him from taking part in its deliberations, except in rare crises in the State. Outside his professional sphere, and that was an extensive one, he had but one predilection—he was passionately fond of music.”

ARNALDO CANTANI, M.D., Professor of Clinical Medicine in the University of Naples. WE regret to announce the death of Professor Arnaldo Cantani, one of the foremost physicians and teachers of Italy, which took place on April 29th. He had been disabled by illness for about two years, but the end came somewhat unexpectedly on the twenty-fifth anniversary of his induction into the chair in which he won distinction as one of the most influential reformers of medical teaching in Italy. Cantani was born at Hainsbach in Bohemia in 1837, but his father was a Neapolitan. In 1855 he entered on the study of medicine in the University of Prague, where he took his degree in 1860. Immediately afterwards he was chosen by Professor Jaksch to be his principal assistant, and for some years he was Privat-docent, taking the professor's place in the lecture room on several occasions with much acceptance. While at Prague he translated Niemeyer's work, Special Pathology and Therapeutics, into Italian. There also he became acquainted with bsalvatore Tommasi, who was destined to take an equally prominent part in the medical renascence of Italy In 1864 the Italian Government offered Cantani the Chair of Materia Medica and Toxicology in the University of Pavia. In 1867 he won by competition the appointment of Physician and head of the Medical Clinic at the Ospedale Maggiorept Milan. Finally, in 1868, the Italian Government invited him to fill the Chair of Clinical Medicine in the University of Naples, which he continued to occupy till his death. So attached was he to the country which had readopted him, that he declined an offer of one of the chairs of clinical medicine in the University of Vienna, which was made to him on the death of Bamberger. 

Cantani's influence as a teacher made itself felt chiefly In the infusion of the modern scientific spirit into Italian medicine, which even thirty years ago was still largely under the sway of " systems," in which facts were' made to fit the Procrustean bed of theory. Cantani laboured by precept and example to rehabilitate the accurate observation and careful collection of facts which had in the sixteenth and seventeenth centuries been the distinctive features of the Italian schools. 

Cantani contributed largely to medical literature on cholera, typhoid fever, rabies, and diabetes. His most important work was his Trattato di Aateria Medica e Farmacologia; his last publication was a work entitled Pro Sylvis, which was a plea for the preservation of forests from the hygienic not less than the aesthetic point of view. 

His funeral was attended by the whole medical faculty of Naples, by representatives of the Senate and Chamber of Deputies, by the Minister of Education, and by the administrative and executive authorities of the province of Naples, and an immense concourse of the general public. Funeral orations were delivered by Professor de Amicis, President of the Medical Faculty, by Professors Gallozzi, De Renzi, and others.

https://babel.hathitrust.org/cgi/ssd?id=uc1.31378008338645;page=ssd;view=plaintext;seq=28;num=14

"According to Vierordt, humans must necessarily absorb 120 grams per day. of albumin, 90 gram. of fat, 330 gram. of hydrated carbides, 2.635 gram. of water and 32 gram. mineral salts. These numbers would be an average. We can take them as such, and take them as a starting point in our studies or our experiences. Let us now study the toll of carnivores, and notice that meat does not is not only albumin, that it contains a quantity of combustible substances: gelatin, fats, muscle sugar, lactic acid. To feed a dog exclusively with meat, it is necessary to give him 40 to 50 grams each day. per kilogram. of its weight: below it will lose weight, above it it will increase in weight. Sees has found that under these conditions a dog absorbs more oxygen than with a mixed diet, and from the therapeutic point of view this is very important: this increase is due to albumin, not to fats nor with gelatins. Digested and assimilated albumin is not used in a single form: according to the uses to which it is to be employed, it will be transformed in various ways; it will take two main forms, which Voit has thus designated: tissue albumin (Organeiweiss), and circulating albumin or provisional albumin (Circulirendes Eiweiss, Vorrathseiweiss), or else blastema or plasma. On this point, Sees is agreement with Bischoff, J. Ranke and Weigelin, and also with our own research. "Tissue albumin" which we prefer to call organized albumin, constitutes the solid parts of tissues, membranes and cell nuclei, it is not as easily attacked by oxygen as "circulating albumin" which I call fluid albumin and which constitutes the amorphous liquid content of tissues. The more meat is eaten, and the more it accumulates in the body of circulating fluid albumin, the more oxygen it absorbs to burn this excess albumin, and produce urea or acid. uric. When a dog is fed on meat and fat, this last substance is an excellent fuel, which spares a lot of albuminates, by burning itself in their place, and taking their oxygen from them, which makes them less combustible. From this results this fact, that such a diet increases the weight of the body, the mass of the flesh, and sometimes also the fatty deposits. In the balance sheet of omnivores, it is about saving as much albuminates, supplying the organic oxidation process with another fuel that is even more economical than fats. By giving the dog meat and hydrocarbons, one could theoretically expect a greater saving of albuminates, since hydrocarbons are more combustible and more oxygenated than fats. In fact, this is what takes place: albuminates are spared, as well as fats, the accumulation of which is thus favored; if the hydrocarbons are introduced in excess, they very markedly decrease, according to Voit, the organic consumption. According to Pettenkofer and Voit, two parts of hydrocarbons are equivalent for the carnivore to one part of fat. Bread alone would not be enough to feed carnivores, or even man; to introduce a normal quantity of nitrogen, it would be necessary to absorb too much starch, which would not be tolerated for long. According to Ranke, collagens do not only spare albuminates, but also fats and even hydrocarbons circulating in the plasma stream: however this excellent fuel would provide little heat. The inorganic substances contained in our food are also of very great importance for nutrition and material exchange; the main ones are: sodium chloride, salts of soda, potash, lime, magnesia, phosphoric acid, water. All these inorganic bodies accelerate the endo- and exosmotic current, the plasma current, and increase the oxidation of circulating albumin. The salts of potash, and especially the phosphate of potash, promote, according to Kemmerich, the production of muscular tissue; according to Ranke, these potassium salts decrease the resistance to cells, would allow an easier passage of the plasma current, and would also promote the organization of albumin or albumin formation of tissue. The excess po- cup would become harmful by the too great depression of the vegetative activity. Water is essential as a liquid menstrual for all processes of diffusion or transformation, oxidation or decomposition, introduction or export. But the excess water in the tissues indicates a sluggish life, a slow and lazy renewal. The balance of herbivores is not essentially different from that of carnivores. The materials used are different, but the results are much the same. Herbivores introduce much more fuel, which promotes fatty deposits; it also seems that they digest at least part of the cellulose, which no carnivore does, including humans. By giving the herbivore nitrogenous food, we do not increase its musculature, but only its reserve of fat. Man is omnivorous, he eats everything: he offers considerable resistance, lives longer than most animals, thanks to his varied and restorative diet, but above all thanks to the influence of his system. nervous system so developed, on vegetative activity and the renewal of its tissues. Meat is certainly his primary food, for hunting, fishing and herding herds preceded agriculture; bread came in later. But the flesh, which man digests very well, remains his best food; it makes him stronger, more energetic, more resistant than is the man living exclusively on vegetables and fruits. And it is with peoples as with individuals: herbivorous peoples degenerate, carnivores progress, in this meaning we could say that the cuisine of peoples is part of their national history. The material renewal varies in intensity according to the various ages. The child oxidizes more, but produces more than he consumes: it is the most plastic age. Likewise, but to a lesser degree in the young man. In middle age, balance is established. In the elderly, despite less consumption, production was no longer sufficient to cover the deficit; regressive metamorphosis wins; it is the organism's first step towards returning to the inorganic state. Let us also note organic individuality as the cause of a variable renewal, too rapid in some, too slow in others. Assuming the correct proportions of the foods introduced, we can distinguish four ways of being of material renewal: 1 ° Regular and balanced renewal; 2 ° excessive consumption; 3 ° self-consumption or autophagy; 4 ° lack of water. In the first case, physiologists admit that all the albuminates introduced replace an equal quantity of organic substances; the more we introduce, the more tissues to renew will be consumed; all the decomposition products found in the urine and other excretions would therefore come from the tissues burned and consumed, and not from the albuminates introduced by the diet. In excessive consumption, there would be an excess introduction of albuminates, only a part of which would serve to renew the tissues, while the other would be burned directly in the blood. The body would not gain weight, since the amount of albuminates intended to increase body mass would be used as fuel. For me, I believe that even in humans well;

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The fats introduced into the organism are burnt there, and give as the last residues water and carbonic acid. The hydrated carbides are starch and scre, and since starch always turns into sugar, all hydrocarbons should be considered sugar. By oxidation they are transformed into lactic acid, and give as last residues water and carbonic acid, as do fats

Page 33

To this order of abnormalities belong according to us: diabetes mellitus, oxaluria, gout, uric and calcareous gravel, adipose polysarchaia. (6) Renewal anomalies with consecutive systemopathy by abnormal elaboration of nutrient materials absorbed into the blood, among which we note: Rickets, Osteomalacia, (c) Renewal anomalies with consecutive systemopathy, for example excess or insufficiency in the absorption of certain food substances, which would be scurvy, hydremia and hydrorgania. 2 ° Renewal abnormalities with systemopathy by constitutional defect, which primarily resides in the tissues themselves, irregularly developed, and, for that, endowed with abnormal reactions or little resistance: the main ones are: Nervous erethism, Scrofulosis, Hemophilia, Chlorosis. 3 ° Anomalies of material renewal with systemopathy, having the character of reaction to agents hostile to organic life, which have penetrated into the tissues or into the circulating blood: these harmful agents come either from the economy itself , or from the outside world, and disturb the renewal of the chemical and morphological cular. Here we find: Fever, Primary phlogosis in general, and in particular acute or chronic rheumatism, certain generalized eczemas, certain fleeting erythemas, urticaria, etc., Virulent infection (contagious diseases and mias - matics), Chemical poisoning (acetonemia, cholemia, ammoniaemia, blood dissolution), Chemical poisoning (lead poisoning, arsenicism, hydrargyrosis, etc., ergotism, lathyria, etc.). In diseases where the whole organism changes its type of vegetation, of chemical direction, the organism transforms food substances to a certain point, without leading them to complete decomposition, thus interrupting the series of normal transformations. Its processes of biological chemistry are no longer sufficient for their task, and the imperfect products of their elaboration remain useless or harmful: these products, by accumulating, all become in the long run very harmful. Examples include diabetes, gout, polysarchaia, oxaluria. The diseases of this group can affect the entire economy more or less seriously, preferably without affecting any organ. Other times the abnormal or retained products almost exclusively affect certain organs or certain tissues, which should have eliminated them in another form, as happens with kidney stones, including oxaluria. At other times the whole organism is affected, but certain organs feel it especially and in a very special way,

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By systemopathies I mean those diseases of renewal, those anomalies of organic chemism, in which the disturbance of the processes of chemical transformation affects the nutrition of the whole organism less than that of a specific type. of tissue, of a physiological and histological system of our tissues. Given an alteration of the blood crase, it is easily understood that certain tissues suffer from it more than others, and that this influence extends to all the tissues having between them a certain affinity of nutritional needs, and belonging to the same histological system. A chemical substance whose presence or preponderance in the blood will alter the nutrition of a bone, can and must interfere with the nutrition of other bones: from then on all other bones will be disposed to become diseased, if an occasional cause occurs. Likewise, a substance capable of making the serous membranes of the joints sick can act on the pericardium, endocardium, pleura and other serous membranes. This is the case in rickets, osteomalacia, scurvy, hydremia, hemophilia, scrofulosis, nervous erythema. Finally, in the diseases which have a character of reaction to the harmful agents which have penetrated into the blood, we find above all affected a physiological system: the skin and the mucous membranes in eruptive fevers, the hemocytopoetic and lymphatic glandules in the ileo - typhus, muscles and nerves in lead poisoning, muscles in lymphadenism, etc. In phlogoses which present several foci, It is understood that there is not a single disease without secondary alteration in the composition of the blood, and without at least a local disturbance of molecular renewal. This disorder can spread secondarily to the entire economy. In the course of these lessons, we will mainly deal with the diseases that have been studied in our studies from the point of view of molecular renewal. The most completely treated will be diabetes mellitus. We will speak of others, as much as is possible in the present state of our knowledge, from the pathologico-etiological and therapeutic point of view.

Page 39:

The Portuguese Amato Lusitano says he cured two diabetics by a very nourishing diet and the use of purgatives. Maybe' Were there cases beginning treated by the diet especially meat. Another Portuguese, Zacuto Lusitano, cures two cases with donkey milk: this is very interesting if we think of the undoubted advantages that we have obtained from the use. lactic acid, and the cure by the milk diet proposed today in England by Donkin. The Italian Cardano had the opportunity to study diabetes on himself, probably it was diabetes insipidus. He also describes a case observed in a young girl, and the first he weighed the urine: according to her calculation, this young girl absorbed only 7 pounds of solid food or drink each day, and gave 36 pounds of urine.

Page 41:

Sydenham came up with an idea, which is like the prelude to current ideas. According to him diabetes is an assimilation disease, in the sense that the chyle is not fully digested in the blood, and should therefore be eliminated by the kidneys as a foreign body. For treatment he strongly recommended a rich diet in meat, and narcotics, especially theriac.

Page 42:

Morton regarded diabetes as a kind of phthisis, and attributed the mild flavor of the urine to the flow of the sweet chyle to the kidneys. In etiology, he cites the influence of heredity, kinship, race. He encountered diabetes in the father and son, and another time in a small child who had lost three brothers to diabetes. 

Mead maintains that diabetes is a disease of the liver: he wants to prove it by autopsies which all showed him steatomatosis of the liver. He explains the sweet taste of urine by the separation of salt from bile. 

Dobson demonstrated that diabetic urine can produce alcohol and vinegar by fermentation: he succeeded in preparing very clearly sugar by evaporating the urine: he also discovered the sweet flavor of the serum of the blood of diabetics, and thus demonstrated that sugar exists in the blood of these patients and is not formed in the kidneys.  According to him, it is a defect of assimilation of the chyle which causes the glycosuria: the sugar of the chyle accumulating unaltered in the blood, would come out by the urine. This shows that Dobson already admitted the passage of sugar from food into the blood; he also admitted an abnormal fermentation, and believed that the acidic breath of diabetics was due to the acid fermentation of the sugar contained in saliva. 

Cullen said the diabetes was neuropathy, a spastic disease. However, he recognized the vice of assimilation of chyle. He denounced the ineffectiveness of all remedies. 

Home recognized that by weighing not only the drinks introduced, but also the more or less liquid foods, the quantity of urine does not exceed the quantity of liquids absorbed; he also noticed that the quantity of urine emitted is greater at certain times. Home made quantitative analyzes, and weighed the sugar obtained; he had in one patient an ounce of sugar for a pound of urine, in another an ounce and a half. He confirmed the fermentation capacity of urine with the addition of yeast, and thus showed that it lost its sweet flavor to take on that of small beer. As for the theory, he accepted Dobson's: he treated his patients with a diet consisting mainly of meat.

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Here we close our second period by noting that several of the authors cited lived after the publication of Rollo's works, works intended to prepare for the era of experimental studies. The third period, therapeutic period, is again inaugurated by an Englishman, John Rollo, who at the end of the last century published the story of two cases of diabetes. Rollo was the first to emit, on the pathogenesis of diabetes, a theory which, modified on various points, became widely later; many authors attribute their authorship to Bouchardat. According to this theory, diabetes is a disease of the stomach with overactivity, with exaggerated secretion of abnormal gastric juice, which converts all starchy substances into sugar; this sugar absorbed in the blood would come out with the urine. Note, however, that Rollo did not know that starch normally turns into sugar. This is why he advises to treat diabetes with an especially animal diet, and with drugs that slow down the activity of the stomach: vines and fats only at dinner and at supper: at breakfast one and a half liters of milk, with buttered bread. As drugs, ammonium sulphide, opium and emetics. This treatment, as we can see, somewhat resembled the Bouchardat or Seegen regime. In the hands of Rollo and his contemporaries, he gave mediocre results, which the author attributes to the inaccuracy of patients in following their diet: he notes that they have frequent indigestion, disgust for meat, gastroenteric catarrhs, and he attributes all this to the meat diet: it seems to us that one could, with all appearance, attribute to the drugs indicated above ammonium sulphide, ipecac, stibiae tartar, etc. My patients tolerate a much more rigorous diet and that for several months; they digest very well and eat perfectly. 

After Rollo we have Bouchardat who adopted the same theories, however modifying them so as to adapt them: 1 ° to the discovery made by Tiedemann and Gmelin, that starch is normally transformed into sugar in the intestine, by action of saliva, pancreatic and enteric juice, 2 ° to this fact, demonstrated by Magendie, that this sugar is normally absorbed in the blood. Bouchardat, also admitting that the cause of diabetes is stomach disease, says that starch is transformed into sugar so quickly that too much of it enters the blood in a given time, and the blood, overloaded with sugar, lets part of it escape through the urine. This is Rollo's theory and the same overactivity of the stomach: it is still the same therapy. Bouchardat menus have become famous: meat, cabbages, peaches, lemons, gluten bread, which should only contain nitrogenous substances, and which, in fact, contains far too much starch. It cannot be denied that, of all the treatments offered so far, that of Bouchardat, which basically is that of Rollo, minus ammonium sulphide and emetics, has had the best fortune and deserved it. The goal was not completely achieved, because the regime is not severe enough, but it is very close to the truth: none of the authors and practitioners who came after Bouchardat could neglect the use of his culinary menu. 

Prout also believed that diabetes is a form of dyspepsia: but he saw it as a defect in stomach activity, a difficulty in assimilating sugary foods. 

Gregor, from London, argued that diabetes resides in the stomach. 

Griesinger expressed the opinion that diabetes depends on rather qualitative disturbances in the digestive functions of the stomach, because the disease often begins with noticeable disturbances in digestion. According to him, the great thirst of the diabetic who eats starches, his less thirst when he eats meat, cannot be explained, with the hepatic theories of diabetes, but rather by gastric digestion disorders, by the rapid transformation of starch into sugar, and rapid absorption of sugar into the blood. In addition, the alteration of the digestive ferment of the stomach is a proven fact; the stomach juice of a diabetic on an empty stomach, obtained by vomiting, would contain a ferment which rapidly transforms starch into sugar, which normal gastric sugar would not. Griesinger regrets that this difference has not been sufficiently taken into account; he also admits as possible that, in the stomach and intestines, the albuminates ingested provide sugar in diabetics.