February 26, 1871
Cantani's fourth patient, Mr Saltavore Musdace, was losing weight from diabetes and was eating an almost exclusively starchy diet, and was cured with an all meat diet. His diet even relapsed, again proving that eating starch would cause diabetes.
Diabetes Mellitus and its dietetic treatment
OBSERVATION IV. - Mr. Salvatore Musdace, 57 years old, from Naples, trumpet of the National Guard. Powerless and losing weight for three years, polyuria of 5 to 6 liters per day, with no known cause, apart from the almost exclusively starchy diet, he entered the Clinic on February 26, 1871; it emitted 3 liters of urine, specific weight 1042; 372 gr. of sugar per day.
After twelve days of rigorous treatment, complete absence of sugar, daily quantity 1,200 cc, specific weight 1022 which fell on May 14 to 1017. This slow decrease in specific weight after the disappearance of sugar is interesting, because it indicates a major combustion of albuminates. We noted here the rapid decrease in sugar, and the persistence of small quantities, after a few days of treatment; this is so in advanced cases: it is only in mild, beginning cases that the sugar immediately disappears completely. This patient is still interesting because of his temperature, which has remained low, 350.7 C., 36 ', rarely 360.5, as long as he has sugar, and 12 to 14 breaths; as soon as the strength returned, the temperature rose to 37 ° and respiration to 16-18.
The recovery of this patient persisted when he resumed the ordinary diet: when he left the clinic, after four months of stay, he weighed 5kil, 6, more than when he entered; When he got home, he was obliged to resume a diet almost exclusively composed of starch and grass. Eighteen months later, he had an abscess of the perineum, which healed after operation, and soon after, hunger, weakness and polyuria returning, he spontaneously began to eat meat: then he returned to the Clinic on the 9th. February 1873, presenting 107 gr. of sugar for 1530 cc of urine. After two days of mixed diet, he had 255 gr. of sugar on 2410 cc of urine within twenty-four hours. After only six days of rigorous diet, the sugar disappeared and never came back. On May 13 the patient went out very well cured.