Carnivore Diet

The Diabetes Mellitus, though sometimes terminating in recovery, is yet well known to be a disease which has in general refilled every remedy hitherto recommended for its removal. Every attempt, therefore, to improve the practice in that affection, may justly be considered as deserving particular attention. The ingenious author of the work now before us, recommends a mode of treatment, which, in some instances, has been decidedly productive of remarkable benefit. It may justly, therefore, be considered as well meriting a fair trial in future cafes. 

The first cafe here related, is that of Captain Meredith, of the Royal Artillery. When he came under Dr Rollo's care, on the 16th of October 1796, he voided about twelve quarts of urine in twenty-four hours. This urine, seven quart-bottles of which he had preserved, having been voided during the course of the night, was of a light straw colour, had no urinous smell, but emitted somewhat of a violent flavour, and was very sweet to the taste. He was affected with 1 excessive thirst, and had drank, during the day, feven or eight quarts. His tongue was somewhat whitish, but moist: there was a cleanness in his mouth, and he spat a white frothy saliva, of a sweetish taste. His appetite for food was variable, sometimes unusually keen, particularly at uncommon times, as during the night. His face was fulfilled, his skin dry, but not unusually warm, and his pulse did not exceed eighty-four strokes in the minute. He was frequently sick, and threw up a viscid matter, of a bitterish taste, but with some sweetness. After eating, he complained of a pain of his stomach, which in general continued about half an hour. He complained of a constant pain in the region of the kidneys, extending forwards, but more particularly in the right, in which there seemed to be a greater fullness and tenderness to the touch. There was likewife a retraction of the testicle, with a weakness, sense of coldness, and at night an (Edematous swelling of the leg on the same side. He also complained of a pain and tenderness of the great toe. He felt also a lingular fluttering fenfation in his belly, extending from the fituation of the kidneys. He was regular in his bowels, though sometimes inclined to costiveness. His stools were of a greenish colour, and had no unpleasant smell. The prepuce of the penis did not retract. It had a whitish appearance, with excoriation and soreness, but was not swelled. His gums were reddish, and had the appearance as if affected by mercury. The teeth felt to him loose. There was a fullness about the eyes, with a turbid yellowish cast, and, he had slight occasional headaches. He had not been particularly restricted in diet, which consisted of animal food and vegetables; and he drank from a pint to a bottle of port wine daily. His other drink was toast-water. He used exercise, both in the way of riding and walking; but he could not walk above two miles without much fatigue. At this time thirty-six ounces, Troy weight, of his urine, analyzed by Mr Cruickshank, yielded by evaporation three ounces and one dram of saccharine extract, of the appearance of molasses, but thicker. According to this proportion, his whole urine for a day, would have yielded twentynine ounces Troy weight; an astonishing quantity to be separated daily from the system. Treating some of this extract with the nitrous acid, Mr Cruickshank procured the saccharine or oxalic acid. With a smaller proportion of the acid, it produced a substance which, in appearance, taste, and smell, could not be distinguished from honey. Two portions of blood, about four ounces each, were taken from his arm. These in appearance exactly resembles what is described by Dr Dobson, excepting that the serum did not impart a sensibly sweet taste. The crassamentum of the first cup had a slight buffy coat ; the craffamentum of the fecond had more. The buffy coat in both was of a bluish colour, similar to "what mercury sometimes produces. A portion of blood from a healthy person, drawn on the same day, was placed in the same room, and in the same circumstances with one of the portions of diabetic blood. In two days the diabetic blood assumed a caseous appearance on the surface, and the whole mass became dry and resinous, without having undergone any apparent putrefactive process. At the end of sixteen days, it remained in the same state; whereas the healthy blood exhibited evident marks of great putrefaction in four days ; and it became necessary to throw it away on the seventh.

When this patient came under Dr Rollo's care, his disease had been of seven months standing. During that time he had taken some remedies, under the direction of an eminent physician at Yarmouth, the principal of which were Peruvian bark and alum. He had fallen away very considerably in flesh and fat; for, in October 1794, when in apparent health, he weighed sixteen stones and eight pounds; and in November 1796, he weighed only eleven stones and eight pounds, showing a loss by the disease of no less than five stones in weight. For six months preceding the attack of the diabetes, he was often sick, and vomited at least two or three times a-week ; and he frequently brought up from the stomach, during these vomitings, different things which he had eaten several days before. These seemed to be unaltered, and the taste was very generally four. He always ate heartily, and drank freely, but not intemperately. He was fond of high-seafoned and fat dishes. He had been subjected to two regular attacks of gout, and had at other times two severe fits of cholic. He had been twice married, and had two children. He was, in the thirty-fourth year of his age, five feet eleven inches high, of a fair complexion, with light-brown hair, and dark-blue eyes. From an attentive consideration of all the circumstances of this case, what appeared to Dr Rollo to be the principal objects of treatment, were, to destroy the saccharine process going on in the stomach, to promote a healthy assimilation, to prevent the supposed increase of absorption from the surface, to diminish the increased action, and to change the imagined derangement of the kidneys. With these intentions the following plan of treatment was resolved upon.

1. His diet to confift principally of animal food; for breakfast, a pint and a half of milk mixed with half a pint of lime water, bread and butter; at noon, plain pudding, made of blood and fuet only; at dinner, game, and old meats which have been long kept, and, as far as the stomach may bear, fat and rancid old meats, as pork, taking care always to eat in moderation; for supper, the same as breakfast.

2. For drink, he was allowed daily four quarts of water which had been boiled, and in which was dissolved a dram of the kali sulphuratum. He was strictly forbid to use any other article, excepting these, either in the way of meat or drink.

3. His skin to be anointed with hogs lard every morning. Flannel to be worn next the skin, and the gentle exercise only to permitted, but confinement to be preferred.

4. A draught to be taken at bed-time, confifting of twenty-five drops of tartarised antimonial wine, and twenty-five of tincture of opium and the quantities to be gradually increased.

5. An ulceration, about the size of half a crown, was directed to be produced, and maintained externally, immediately opposite to each kidney. And, lastly, his bowels were to be kept regularly open, by a pill of equal parts of aloes and soap.

This treatment was begun on the 19th of October, and, so soon as the 21ft, some changes occurred. He made, in twenty four hours, only six quarts of urine, and drank only three quarts of the sulphurated alkaline water. The urine was not so pale, had a cloud in it, and was more urinous in smell. 

On the 1ft of November the urine did not exceed four quarts, while it was of a higher colour, and more urinous smell. His skin was moist and he perspired freely; his stools were large, and very offensive, and he was in every respect much easier, though he complained of much pain from the ulcerated parts of the loins. Imagining that the quantity of alkaline salt, which he took daily in the kali sulphuratum, might have some improper effect on the kidneys, it was resolved to try hepatifed ammonia, on the suggestion of Mr Cruickshank, who was of opinion, that it might prove a more certain and active medicine in diminishing the action of the stomach, as well as the action of the system m general. He was therefore directed to take five drops of it, in each half-pint tumbler full of water, which he used as drink. The ill day he took thirty-five drops at different times, which in the evening, produced sickness and vomiting, with giddiness and drowsiness. He was therefore diredled to leave off the hepatifed ammonia for one day, and then to begin with two drops to each tumbler full of water. On the fourth, he drank only two pints of water, and made only two quarts of urine, which was not sweet, and deposited a red sandy, or lateritious sediment. 

On the 5th of November, the opiate at bedtime was discontinued ; and on the 8th the rubbing with the hogs lard was left off. Between the 4th and 14th of November, in consequence of some irregularities on the part of the patient, particularly drinking beer and tea, the disease was to a flight degree reproduced. 

On the 14th, therefore, an entire abstinence from vegetable matter was directed; nothing was allowed approaching nearer to it than milk; and even this was directed to be left off, and strong beef-tea substituted, should the disease not disappear. This soon produced a favourable change, his urine became again of a much Higher colour, and its smell and taste quite urinous. He afterwards continued for some time with tolerable regularity on the course already mentioned, and by the 18th of December his disease seemed to be in a great measure overcome; he was therefore desired to eat half a pound of bread as a daily allowance, and to take exercise more freely. 

On the 30th of December, Dr Rollo found that since the 18th he had continued free from the disease. He was now in high spirits, and rapidly gaining flesh. His urine did not exceed two pints in the twenty-four hours. It was often under that quantity, and perfectly urinous. He now weighed thirteen stones and one pound; so that he had gained about alone and a half lince the end of November; which furnished a convincing proof, not only of the removal of the disease, but also of the disposition to it. 

After this period, Captain Meredith might be considered as continuing free from complaints. He took exercise freely, both in the way of walking and riding. He ate a sufficient proportion of bread, potatoes, and other vegetables, without any inconvenience- His appetite was good and natural, and his bowels regularly open. His urine continued perfectly natural, and, in general," did not exceed a quart in twenty-four hours. Of this urine, which was of the ordinary taste and smell, nine ounces were evaporated, -and yielded of a brown and pungently saline bitterish-tasted matter, without tenacity, three drams and twenty grains, a product excessively different from the saccharine extract resembling molasses, which his urine yielded in October. The product now obtained was very nearly the fame, both in quantity and quality, as Dr Rollo obtained from his own urine, which, he had every reason to believe, was in the healthy state. About the middle of March, Captain Meredith continuing in a state of health, was ordered on active service; to which he very readily assented, being satisfied that his health now enabled him to execute the duties of his station.

4th May, 1797- I SEND you an extract of the case of Walker, with Dr. Hope's permission, and you may do with it whatever you please. The effects of the animal diet on the quantity and quality of the urine are perfectly evident, though the case could not be carried to an absolute termination, from the impatience and instability of the patient. In Hospitals, where patients three three or four times in the day every person about them eating vegetables, a trial of an entire diet of animal food can hardly be expected.

James Walker, a field-labourer, was admitted by Dr. Hope into the Clinical Ward, with a confirmed Diabetes, on the 1st November, 1796. 

"His appetite is voracious, and his thirst so urgent, as to make him defire from ten to fixteen quarts in twenty-four hours. His urine is praeternaturally copious, and he has a frequent inclination to pass it. It is limpid, of a light green colour, and having a slightest sweet taste. He is much emaciated ; and his feet and ankles swell towards evening. Pulse 96. Skin parched and rough. Body costive. 

He recollects, on a frosty morning in December 1795, having slept fome hours in an open cart, On the May following the above symptoms appeared, and have increased ever since. He has feveral times been the object of medical treatment; but without permanent relief. 

• 2d. Milk daily, and as much drink as he chooses. 

• 3d. Urine 22 pounds, Ingefta 20 pounds.. AtL 153

• 4d. Urine 13 pounds. Ingefta 17 pounds. The urine becomes turbid on the addition of lime water; when evaporated it affords an extract like molasses, which is sweet to the taste. This matter mixed with lime, exhales the odour of ammonia. 

• From this day to the 29th December, he remained nearly in the same state, the quantity of urine fluctuating between 12 and 18 pounds in 24 hours. During this interval he took some ferrum vitriolatum in the form of pills; ufed the cold shower bath, and took occassionally fome emetics and laxatives ; —the stomach being at times deranged, and the coflivenefs very obflinate. Under this treatment he feemed to get a little stronger, but without any important change in the general symptoms of the disease. It was agreed to try the effects of animal food, as lately given with success by Dr. Rollo at Woolwich, an account of which was tranfmitted by Dr. Woollcombe to Mr. Marcet. 

• December 29th, Dr. Hope gave the following report. Ingesta 17 pounds; urine 13 pounds. Five pounds of this urine have afforded 5ounces of a thick saccharine extract. He has had for a month, an unpleasant sense of burning heat in the soles of his feet during the night. He is directed to abstain from vegetable food in every shape. To have two eggs for breakfast. Boiled meat and fleaks alternately for dinner. Eggs, or cheefe for fopper. For drink eight pounds of weak beef tea, and two pounds of weak peppermint water. 

• 30th December. Solid ingested about two pounds ; drink ten pounds ; urine nine pounds. Let him have two pounds of flesh meat for dinner; half a pound of cheese for supper; and three eggs for breakfast—drink as before, Ingefta (drink, and food) ten pounds ; urine five pounds, which exhales an unusually strong urinous smell. Had a partial sweat over the trunk and head in the night. Mouth moist; no sourness. of stomach. 

• January 1st, 1797- Solid ingesta as usual ; drink nine pounds ; urine eight pounds, more limpid than yeflerday, and has a sharp acid odour. The breath has the fame smell . The colour of the urine, however, is not changed, on addition of syrup of violets. There is slight headache and sickness. The tongue appears much cleaner than usual. Has had a stool. Contin. diaeta animalis. 

• January 2d. Solid ingefta the fame; drink eight pounds; urine fix pounds. No flcknefs or hcadach ; tongue clear; the burning heat of the feet as before. One Joofe ftool. Contin. 

• 3d. Drink 10 pounds; urine 7 1 pounds, of a deeper yellow than formerly; tongue natural. Contin. 

• 4th. Drink ten pounds; urine feven pounds. Contin. 

• 5th. Drink nine pounds ; urine 6{ pounds, more yellow, with a peculiar (not urinous) odour. Contin. 

• 6th. No report, as laft night he went out, returned to the ward drunk, fo that his urine could not be meafured. 

• 7th. Drink 7 pounds ; urine 6 pounds, having the same peculiar smell, 

• 8th. Drink 7 pounds; urine 6 pounds; body coftive. Contin. diaeta animalis. Sum: ftatim pil. rhoei. comp. ^ l'et iterum eras mane. 

• 9th. 156 Qtfa Drink iix pounds ; urine four pounds ; a copious ftool this morning; ftrength not changed fince he began the animal food. Contin. et habeat aq. menth. piper, lbiv pro potu. minuatur quantitas decocti carnis ad lbiv. 

• 10th. Solid food as formerly ; drink feven pounds ; urine five pounds ; no flool. Sum : flatim pil. rhcei. comp. B 1. 

• llth. Drink fix pounds ; urine four pounds ; three llools this morning. Contin. diaeta animalis, 

• 12th. Drink fix pounds ; urine four pounds ; two ftools—he thinks his ftrength is fomewhat impaired within thefe two or three days. Adeat eras mane balneum frigidum. Drink feven pounds ; urine five pounds ; bore, the bath well. Contin, 1 4th. Drink eight pounds; urine fix pounds. Contin* 

• 1 5th. Drink eight pounds ; urine fix pounds. 

• l6tk Solid food as before; drink eight pounds; urine fix pounds, of a light ftraw colour, and with the peculiar fmell it has had for fome time. The urine of the 14th being evaporated, afforded matter of confiderable confiftence, with a ftrong faline, but fcarcely perceptible fweetifh tafte. 

• 17th. Drink eight pounds ; urine fix pounds ; thinks he is weaker. 

• 18th. Drink eight pounds; urine 5| pounds. Contin, IQth and 10th. Drink each day eight pounds ; urine fix pounds. Contin. 1\Ji January. Drink feven pounds ; urine five pounds. He has left the Infirmary to-day, by his own defire, to return to the country." 

• 4th May. Dr. Hope told me a few days ago, that he had just then. received a letter from Walker, who says that since he left the Infirmary he has become weaker; and there is some expectation of his returning foon to the Hospital to resume his treatment. But it is doubtful whether when he was in the Clinical Ward he observed strictly the diet preferred. At least he was accustomed to go about freely; and the nurse told me repeatedly, that she suspected he did not entirely abstain from indulgencies of eating and drinking out of the house.

From Dr. Cleghorn, Lecturer in Chemistry, and one of the Physicians to the Infirmary at Glasgow. Glasgow May l9 1797. 

SOME months ago I was honoured with your excellent pamphlet on Diabetes. At that moment I had two diabetic patients in the Royal Infirmary of this place, and I began instantly to treat them on your plan. They are both cured ; and I have delayed so long to thank you for your politeness, in the hope that I might be able to inform you of this new success. 

CASE L John M'Lean, a Porter, age 38, December 9th, 1796. 

Four months ago had a fever, after which while yet weak, he began to work hard. Soon afterwards he observed his urine more abundant than usual, amounting daily to 24 pounds, or more. 

Though his appetite be voracious, he becomes leaner from clay to day, and is so weak that he cannot walk a few steps without panting. His mouth is parched, tongue red, thirst extreme, belly collive. Pulse 84. 

A few days ago he had a slight cough, with pain in the right breast ; but these complaints have abated. The feelings about the stomach when he thinks himfelf hungry, differ from those he formerly had; they are more uneasy, and the uneasiness is less removed by taking food. He is often troubled with flatulence ; and complains constantly of weakness or pain in the back and loins. Has used no medicines. On examining the urine it was found limpid and very sweet. A pound of it yielded by evaporation more than an ounce of a thick brown extract, like treacle in appearance and taste. 

December 10th. He was ordered an ounce of castor oil, and the same quantity of compound tincture of fenna. His loins were directed to be rubbed every evening and morning with anodyne balfam. Equal parts of kino and ruft of iron, formed into pills rcki pills of five grains, with extract of chamomile^ were to be given, two for a dofe thrice a day. His drink and urine were ordered to be meafured daily, and the following reports, abridged from the Infirmary Regifler, fhew the refult. 

11th and 12th. One stool ; urine 28 pounds ; has drank about 14 pounds, besides the usual allowance of beer and broth. 

13th. Urine 27 pounds ; drink 8 pounds ; has had double allowance of food. Belly natural. To take 8 pills daily. 

14th. Feels himfelf a little eafier and stronger. To drink a pint of alum whey daily at different times. To have the oil and tincture of fennawhen coftive. In this courfe he persevered till the 17th of January, 1797. The quantity of his urine diminifhed daily. On the 16th December it amounted only to 20 pounds ; next day to 1 8 ; next to 1 5 ; next to 13; but on the 20th it rose to 16 pounds, without any cause that could be pointed out, unlefs the increafe proceeded from coftivenefs. Next day it fell again to 13; on the 24th it rofe to 1 5 : after which it varied from 13 to 7 J pounds. This was the quantity voided on the 17th January. It never fell below 71; most commonly it was between 8 and 10 pounds. Meantime the patient confidered himfelf as cured. He slept comfortably, sometimes not rising during the nighty never oftener than once. The feelings about his stomach were more agreeable ; his countenance looked less ghastly, and he felt his strength returning apace. On examining his urine, however, I had the mortification to find it nearly as sweet as ever. I confidered the cure therefore as very incomplete, and I expected that the urine would soon begin to increase, as it had uniformly done in every cafe that I have hitherto feen, and I have feen a confiderable number. 

While under this painful apprehension I received Dr. Rollo's pamphlet, which seemed to me to contain a more distinct theory, and a more reasonable practice, than I had ever met with before. As I could not immediately procure the hepatifed ammonia, I ordered him to use for drink four pounds of water, containing a drachm of lixiva fulphurata. The alum whey to be continued. 

Jan 20 Urine 8 pounds, sweet. Has used vegetables and milk freely. Took 3 pounds of the ammoniated water. The necessity of abstaining from vegetables was explained, and enforced, and he was ordered to continue the water. 

February 10th. This morning took 15 drops at once, with no other effect than a sense of heat in the stomach. Urine 6 pounds, less natural in tafte and smell. Finding himself strong enough, he asked leave to go home, (to the fuburbs of Glafgos) to manage some business which required his prefence. He promised to abstain from vegetables, to take his drops, and to return if he became worse. I have seen him several times at work, and this day, being the 10th of May, I received from his own mouth the following account. 

In 24 hours his urine is about 5 pounds. He taftes it very often, and it has never been fweet, but after getting little animal food for days together (which has happened more than once) it has fometimes been of a four fmell. Formerly he could carry on a wheelbarrow three hundred weight ; at present he carries one hundred weight, and he can walk as well as ever. Two days ago he went express to Paisley, received an answer to the letter he carried, and returned to Glasgow in three hours and a half (about 14§ miles). 

Occafionally he has taken 60 drops a day of the hepatifed ammonia, which he likes, because it gives him an agreeable feeling of warmth, and never produces any inconvenience. For two weeks, however, he has had none, since which his urine has not increas›ed in quantity, has not been sweet, and when evaporated lately by himself, and by a neighbour of his, whose curiosity he has excited, it yielded no sugar. The residuum could not be diftinguished from that of an equal quantity of healthful urine, evaporated at the same time with great care and sagacity. The only kind of animal food that he can procure in sufficient quantity is blood, which he mixes with fat and a little meal. Even this homely fare he finds it difficult at prefent to procure regularly. He was always lean, and is now rather more so than before his fever ; but though he works very hard, he thinks himself stronger, and more fleshy, than when he left the Infirmary. He sleeps well; is regular in his belly, and free from every complaint, except occasional pains about the muscles of his breast and arms, anting obviously from the intense colds to which he has been very much exposed, as he plies near the river from morning to night. He is the father of several children, but since he has been seized with Diabetes—Coitus nullus. Erigitum nunquam : ne quidem femel rigefcit. About a month before he left the Infirmary, the other patient gave the same account of himfelf.

"It was agreed to try the effects of animal food. He is directed to abstain from vegetable food in every shape. To have two eggs for breakfast. Boiled meat and steaks alternately for dinner. Eggs, or cheese for supper. For drink eight pounds of weak beef tea, and two pounds of weak peppermint water. Solid ingested about two pounds. "

The second case which Dr Rollo has here very minutely detailed, but into the particulars of which we cannot propose to enter, is that of a general officer in the 57th year of his age, with whom the urinary discharge amounted to ten or twelve pints in/the twenty-four hours; and, while the urine had a very sweet taste, he was at the same time subjected to the other common symptoms of diabetes. After his disease had been of at least three years Handing, and after recourse had been had to the assistance of several eminent physicians, without benefit, he came under Dr Rollo's care, in the beginning of January 1797. 

Nearly the same plan of treatment, particularly with respect to the diet of animal food, was here directed, as in the case of Captain Meredith. In a very short time, a remarkable change for the better was produced. His thirst was diminished, and his urine rarely exceeded two, three, or at the most, four pints, in twenty-four hours, being at the same time of the natural sensible quantities. In this way he continued to the end of February, gradually recovering flesh and strength. He now resolved on returning to his residence at Portsmouth. He had very great impatience under refraction. But on parting from Dr Rollo, he was told, that, for preventing the return of his disease, everything depended on himself; and he acknowledged the truth of the observation. He bore his journey very well, and arrived at Portsmouth on the 27th of February. But having eaten something improper on the road the day before, he was attacked with a bowel-complaint. On the 6th of March he had a return of his bowel-complaint, from eating beet-root. On the 9th he had the sanction of a physician to eat what he pleased, and to drink wine. The disease was soon reproduced, for his urine became sweet, and was increased in quantity, with a return of thirst and feverishness. Yet this case, Dr Rollo justly observes, adds strength to the conclusions derived from the former case. From these two cases Dr Rollo draws some general inferences. He concludes, 

1. That the diabetes mellitus is a disease of the stomach, proceeding from some morbid changes in the natural powers of digestion and allimulation. 

2. That the kidneys and other parts of the system, as the head and skin, are affected Secondarily, and generally by sympathy, as Well as by a peculiar Stimulus. 

3. That the stomach-affection consists in an increased action and secretion, with vitiation of the gastric fluid, and, probably, on too afiive a state of the ladteal absorbents. 

4. That the cure of the disease is accomplished by regimen, and medicines preventing the formation of sugar, and diminishing the increased action of the stomach. 

5. That confinement, an entire abstinence from every species of vegetable matter, a diet solely of animal food, with emetics, hepatifed ammonia, and narcotics, comprehend the principal means to be employed. 

6. That the success of the treatment in a feat measure establishes the five preceding inferences. 

7. That the saccharine matter of the disease is formed in the stomach, and chiefly from vegetable matter, as has been shown by the immediate effects produced by the abstinence from vegetable matter, and the life animal food solely. 

8. That acescency is predominant in diabetic stomachs, which continues even sometime after the entire abstinence from vegetable matter, and after the formation of sugar; and that while such acescency remains, the disposition to the disease may be supposed to continue. 

9. That the saccharine matter may be removed in three days, and, by avoiding vegetable matter, will not again be reproduced ; but we are not yet able to state accurately, when the disease, and the disposition to it, can be finally removed. 

10. That there are two circumstances to be considered in this disease, which we may separate in the progress of the treatment. As it has been shown, that though the formation of sugar was prevented,yet the increased action of the stomach remained, and maintained the defect of assimilation, which prevented nutrition. Hence two objects occur in the cure ; for it is not yet determined, whether the preventing the formation of sugar, by an entire abstinence from vegetable matter, and the use of animal food, with fats, if properly persevered in, might not ultimately comprehend the other, namely, the removal of the morbid action of the stomach. 

11.  That the lungs and skin have no connection with the production of the disease. 

12. That the quantity of urine is probably in proportion to the quantity of fluids taken in, and has but little dependence on absorption of fluids, from the surface of either skin or lungs. 

13. That though the disease has been shown to consist in an increased morbid action of the stomach, and probably too great a secretion, with vitiation of the gastric fluid ; yet the peculiar specific condition of either, as forming the disease, is acknowledged to lie in obscurity, and must remain so till the physiology of healthful digestion be properly explained and established. 

14. That the first case had only been of about seven or eight months duration when the treatment commenced ; but the Second case had been upwards of three years continuance. The age of the one thirty-four; of the other, fifty-seven ; circumstances which constituted material differences, though they seemed not to create corresponding difficulties in the treatment, so far as the direct removal of the complaint was concerned. They may however retard, in the one instance, the entire restoration of health. 

15. That, in both cases, deviations occurred in the management, and were respecttively followed by reproductions of the disease, and, though disadvantageous to the patients, have confirmed our views of its nature and treatment. 

16. And, lastly, That from both cases we may warrant this general conclusion, that the diabetes mellitus is so far understood as to be successfully cured. 

To these histories and observations, Dr Rollo has subjoined some remarks respecting the diabetes mellitus, which have been communicated to him by different correspondents, since the dispersion of his notes on the case of Captain Meredith. With regard to the causes of the disease, he observes, that from Dr Falconer's letter it appears, that one case was produced by excessive indulgence diligence in spruce-beer; that in one patient of Dr Cleghorn's, the disease seemed to have arisen from hard work when recovering from a fever, and in another from his being much addicted to the use of large quantities of sugar; and that the patient Whose case is related by Dr Gerard, had been subject to pyrosis, and an excessive discharge under the form of perspiration, previous to the attack of diabetes. With regard to the nature of the disease, Dr Rollo observes, that the appearances found by Dr Baillie, on direction, an account of which will probably soon be published, may have been sequelae of the disease. Mr Abernethy, he remarks, found the serum of the blood in diabetes to be turbid ; and observed, that sugar taken into the stomach increased the saccharine matter in the urine. With regard to the treatment, Dr Rollo informs us, that in one case of diabetes mellitus, Dr Duncan found fat meats serviceable; that Dr Falconer recommends mephitic alkaline water; that Dr Beddoes Mentions a case where Bristol water cured the disease ; but that Dr Currie, who has seen several cases of the disease, never saw one of these cured in which the urine was sweet.

The case of James Walker, treated in the Royal Infirmary of Edinburgh, by Dr Hope, shows, according to Dr Rollo, the good effects of animal food. The treatment in this manner was begun on the 29th of December, when the daily quantity of clear urine of a sweet taste amounted to thirteen pounds. On the 31ft of the month, two days only after the commencement of this treatment, the quantity of urine was reduced to five pounds, and it had acquired a strong urinous smell. The two cases treated at Glasgow, by Dr Cleghorn, show also the good effects of a diet consisting entirely of animal food ; and prove also the influence of commotion in the bowels on the quantity of urine. But the most striking case, Dr Rollo observes, is that related by Dr Gerard of Liverpool, from which it appears, that in diabetes there is no absorption of fluids by the skin, and that animal food alone, if duly persevered in, may cure the disease, though such perseverance be only of a very limited duration. Dr Rollo concludes his remarks on diabetes, by observing, that hepatifed ammonia appeared to him to be a very powerful medicine. But it must, he tells us, be prepared according to Mr Cruickfhanks's method. The ammonia must be pure, and completely saturated with the hepatic gas. To produce its narcotic effects, full and sudden doses of it must be given ; but these require judgement, and an acquaintance with the exhibition of the medicine. It should not be mixed up in-draughts, or in any other form, as it is readily decomposed; but it should be dropt from the P^ial, at the time of using it, into a proper Vehicle, and taken immediately. Distilled water is, he thinks, the best vehicle.