January 2, 1876
Cantani summarizes that his cure only works if the patient wants to be cured, and those who return to mealy foods and sweets get sugar in their urine once more.
Diabetes mellitus and its dietetic treatment
LESSON SEVEN Observations of diabetics not completely cured or dead.
SUMMARY. Cases of diabetes which cannot be cured due to lack or insufficient treatment. Cases which do not heal completely with the treatment. Absolutely incurable cases. · Clinical observations of the cases of diabetes observed by me, and which are not cured completely (LXXIV to XCVII).
Observations of cases of diabetes followed by death (XCVIII to CV). GENTLEMEN, If the cases exposed in the preceding lesson are to be regarded as cases of cure, since the patients can return to the mixed feeding, provided that they never again abuse mealy and sweets, the cases that I will report to you today must be regarded as improved: one could say that their diabetes is suppressed, that the diabetic symptoms are overcome; however, since glycosuria persists, or recurs on the first attempt at sugary foods, these cases cannot be considered cured.
Let us note first that among all these patients, there are some who could not be cured, only because they did not take the cure for a sufficient time, in fact because they do not want to be cured; this is the greatest number. The sugar disappeared, the patients quickly left the cure, and the sugar returned. I have seen many of these cases, and others have seen them as well. A month, and even two, of very rigorous cure seldom suffices, and only in recent diabetes: it takes at least three months, and three more months to arrange for a gradual return to the mixed diet, when these cases cannot be considered cured. the patient will not have sufficient confidence and patience to continue the treatment, it will be better for the doctor not to recommend it: he will spare himself a disillusion and will spare his patient a painful and fruitless treatment. There is another series of patients who do not recover because, with them, the disease is too advanced: treatment can improve their condition, but no longer eliminate the disease. Others, who can be considered almost cured, can eat anything except cane sugar and starch: still others can only tolerate vegetables low in glycosides, but milk and fruit. bring back melituria: finally others can only eat meat and fat, and are forced to continue the rigorous cure indefinitely, under penalty of seeing glycosuria reappear: in the long run, the sugar reappears in the urine despite the diet. There is another group of cases in which diabetes has to be declared incurable, although it improves steadily as long as the patients remain under our treatment. Indeed, we see the painful symptoms that we can really call diabetic disappear, thirst, polyuria, impotence, progressive slimming; the individual lives in a tolerable situation, he can satisfy his obligations, provided he continues a rigorous cure or so. But there is still glycosuria, which cannot be suppressed by any means (except chronic man-made poisonings with opium, etc.). It goes without saying that you cannot cure a diabetic, nor logically have this claim when consumption and the general stagnation have brought about the irreparable atrophy or the destruction of an organ essential to the continuation of life