Although advocating the employment of vegetable diet in cases of diabetes of the second class, I do not wish it for a moment to be supposed that I agree with Piorry in thinking that the cause of death, even in this form of diabetes, arises from the loss of sugar; for, on the contrary, I think it springs from the inability of the body to assimilate the sugar it possesses. In such cases, therefore, I give vegetable food, not because it contains sugar, but because it possesses many of the other substances necessary for the purposes of nutrition, which neither exist in the same quantity nor in so easily an assimilated form in animal diet. 

It is well known from the reports of travellers among savage nations, that men restricted solely to animal diet must consume an almost fabulous amount in order to obtain sufficient of all the ingredients requisite in the processes of life. "We know, too, that an animal can be most effectually starved by limiting him to one particular element of food, although that element be even albumen. The benefits derivable from Piorry's plan of treatment, therefore, in my opinion, arise from the fact that when he gives sugar he at the same time ceases to restrict the patient to animal diet, and that in the mixed food they find many of the materials essential to life much more abundantly and in a more easily assimilated form than in animal diet. I shall now give a few typical cases illustrative of the two principal forms of diabetes. 

Diabetes from Excessive Formation. 

In the beginning of 1860 a young gentleman, aged 19, suffering from diabetes, was brought to me by his brother, a Medical Practitioner, who had detected the disease two year previously. This patient had already been under various systems of treatment. What appeared to agree with him best was animal diet, coupled with. small doses of chlorodyne. 

To look at the patient one would have thought that he was a perfectly healthy individual. His weight was 135 lbs. ; the appetite was moderate ; and the amount of urine passed was not at that time excessive. The object of bringing the patient to me, it appeared, was in order that I might, if possible, suggest some remedy to replace the chlorodyne, the constipating effects of which were anything but agreeable. On carefully inquiring into the history of the patient, the case appeared to be one of diabetes by excess, and the origin of the mischief could in some measure be traced to some irritation in the liver, which was painful at its lower margin, the pain being much increased on pressure. Having an intelligent Practitioner to deal with, I at once gave my view of the case, and explained how, as scarcely any two cases of diabetes are precisely alike, it would be necessary to try the effects of different forms of treatment in order to discover what would be best for this particular case. The following table is an abstract of the results : 

TABLE 

The average amount of sugar passed by this patient during the next six months being from fifty to sixty grammes (775 to 930 grains) and his -weight 156 pounds, a quantitative analysis of the sugar -was no longer thought necessary. I may add that-when I last saw the gentleman in August, 1864 (on the occasion of his bringing to me a poor lad, -whose case I shall presently relate), he looked in excellent health, being, as he said, -without any feelings of discomfort, although he had still to continue his medicine, for as soon as he neglected it, the sugar again increased.