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Some Remarks on These Communications.

THESE communications are of great importance in the further elucidation of the history, nature, and treatment of the Diabetes Mellitus; and they will probably supersede any more cases in detail. A concise account, however, of such as are attended with new circumstances, and which have terminated, either successfully or fatally, with diffections, must still be required. The continuation of Walker's case, as described by Doctor de la Rive, shows the same unsteadiness, and inefficacy of any other means than the animal diet, and likewise that his patient, by more perseverance, might have obtained a perfect cure.

Doctor Gerard's first case points out a corresponding effect in the female as in the male, by the irritating stimulus of the saccharine matter in the extremity of the urethra ; it also exhibits the effect of vomiting in diminishing the quantity of the urine ; and alludes to some advantage having been obtained from the carbonate of ammonia. 

The second case marks a dropsy previous to the diabetic accession; also the same affection of the urethra as the other; and the patient having more resolution in complying with the means of cure, was likely to obtain a restoration of health. Both show the propensity to deviate from a rigid observance of the animal diet, and the conviction that it is efficacious when strictly pursued. 

Doctor Cleghorn's continuation of the cases of Roger and Maclean, afford additional satisfaction, but more particularly that of the latter. This man died evidently under the effects of a lung disease, during which the Diabetes had not returned. From the appearance of the lungs on dissection, it was supposed that they had been affected previously to the diabetic attack; or, at least, that they were dissused to inflammation, on getting cold, while in the infirmary with the disease. Dissection, while it exhibited no morbid derangement of the kidneys, neither did it of other parts. It is said, the kidneys, though found, were more flaccid than usual, and that the bowels were very pale.

He gives also a concise account of four other cases of the Diabetes Mellitus, treated in the Glasgow Infirmary. The first-of whom was a man who caught cold under mercury, to which the patient described his disease: he got completely well by the animal diet. The insensibility of his stomach to emetic medicines is attributed to an original peculiarity of constitution, which had no connection with the Diabetes. 

The remaining three patients were women, one of whom had the disease while giving suck, which obliged her to wean her child. Had this patient been admitted during her nurfing, it might have been ascertained whether the milk contained more than the usual proportion of saccharine matter. The other two cases show only the efficacy of the animal food. There is a fifth mentioned as being under the treatment, with equal hopes of success. 

The Doctor takes notice of a singular disease among horses, which had some general resemblance to the Diabetes in the human subject:. The urine of one of them was hastily examined, and it was found sour. 

In his letter of the first of July, he gives an account of an acute disease, which attacked one of the diabetic patients, after her dismissal from the infirmary, terminating fatally. The dissection showed inflammation of the bowels ; it also exhibited the kidneys as being enlarged, uncommonly soft, and pale. From this case, and that of Maclean the Doctor supposes, that animal food, when so rigidly persevered in, strongly disposes to inflammatory affections.

(explained at end by Dr. Rollo)

Doctor Storer had met with seven distinct cases of the disease, and he avers with Doctor Currie, that after it had been completely formed, he had never seen it cured by the former methods of practice. He gives a satisfactory account of Doctor Aldrich's case, the Gentleman of 77 years of age ; which shows the effects of our plan of treatment in a very favourable and impartial point of view. He joins in the common regret, that the great desire for variety of aliment, forms a strong bar to the successful application of a diet confining entirely of animal food. He describes a case where Bulimia preceded as well as accompanied the diabetic disease. The account of a mild or chronic species of it, as prevailing in families is important. In this form it is said to be occasionally suspended, and the patient may live to a tolerable age. It does not seem, so far as the Doctor's observation has gone, to depend on any constitutional disposition ; neither does he determine whether this constitutes a difference in the nature, or merely in the degree of the disease. https://www.carniway.nyc/history/animal-food-may-alone-cure-the-disease

https://www.carniway.nyc/history/doctor-aldridge-uses-carnivore-to-cure-diabetes

Doctor Jameson's case of Nixon exhibits a distinct history of the disease, which had been of eighteen months standing. The animal food reduced the saccharine and extractive matter from three ounces, which had been obtained from a quart of the urine to one ounce and two drachma in the short space of 19 days. On the whole, it furnishes an instance of the efficacy of our plan of cure.

Mr. Shirreff's attentive observation has rendered his diabetic case interesting. The subject of it is of an earlier age than that in which the disease commonly appears ; a stomach affection evidently preceded it, during which she eat freely of fruits and sweetmeats. It would seem, that the urine undergoes manifest changes, at different hours after eating, which is more remarkable, according to the substances eaten. In this case, after partaking of vegetable matter, it was found clear, and sweet ; the next portion higher coloured, and insipid ; and when the interval was long, as in the night, the urine was more natural. This is an important fact: in support of the opinion, that the saccharine matter is evolved during the process of digestion.

Mr. Houston's patient shows also, a long continued stomach affection, previous to the detection of the Diabetes, during which she likewise indulged in the liberal use of fruit : but in this case the mind was particularly concerned, being under the influence of the depressing passions. The circumstance of the acid urine is singularly curious ; but it remains to be further ascertained.

Doctor Cleghorn, it may be remembered has mentioned that he found the urine sour, in the case of the horse disease.

Dr. Pearson's three cases, with the ingenious remarks accompanying them, are valuable. The first, shows the same infeasibility to emetics, as in one of the cases related by Doctor Cleghorn. The direction exhibited no morbid appearance, or even any change of the kidneys, or any other part, except in the myfentery and bladder, which were found thickened. The urine contained in the latter was not sweet. This case is peculiarly important to us, from the detection having shown no change whatever, in the natural appearance of the kidneys; a fact strongly supporting our doctrines. The second gives a very distinct account of the disease, which was treated in the best manner, by the remedies usually employed at that time; but without relief. The third contains facts and arguments, in opposition to the theory of the disease, as depending on a primary affection of the kidneys, which must have their weight. The opinion, with regard to the effects of animal and vegetable food, in the formation of saccharine matter, differs from that we entertain. It is an incontrovertible fact, that animal food solely used, deprives the urine of every portion of saccharine matter, so completely, as not to be discoverable by any chemical process, nor by fermentation. See Doctor Gerard's case, page 215.

The experiments of Mr. Cruikshank not only show the difference between what may be termed animal and vegetable sugar; but that the sugar in diabetic urine is very probably the entire product of vegetable substances. There are also some other points in which we cannot perfectly agree ; but these will appear from our general account of the disease.

Doctor Marshal's case is valuable. The appearances on dissection show the state of the kidneys, which has been frequently met with in this disease : but the peculiar condition of the stomach and blood have not been hitherto found, at least not described. The stomach exhibited marks of disease ; and as the villous coat was of a red colour, an increased action of its vessels having happened was apparent. The peculiar smell of the blood, pointed out a great deviation from the natural state ; but it is to be regretted that it had not been more particularly examined. The circumstance of the unmixed chyle is singular. The whole, we apprehend, justifies this conclusion that more morbid changes in the organic powers of assimilation, than of any others in the body, were manifested ; of course, we deem it a fact strongly in favour of our doctrines of the disease.

Doctor Willan's case exhibits a very successful adoption of the animal food, without the use of any other remedy. The disease had been probably of twelve months duration, and was attended with nearly its worst symptoms. In eight days the urine was reduced from 12 to 2.125 pints in the 24 hours ; and in 14 days more, it was probably deprived of the unnatural proportion of extractive, as well as saccharine matter. In five weeks, the recovery seemed to be far advanced. If the same steadiness of conduct, in adhering to the dietetic treatment, continues, there is every reason to expect a perfect restoration of health ; and it will furnish an additional fact, in support of our opinions of the nature and treatment of the disease. 

Mr. Thomas's case, from the minuteness, accuracy, and result of the direction, throws considerable light on the nature of the Diabetes Mellitus, and affords another remarkable fact in favour of our ideas on the subject. The apparent natural condition of the abdominal viscera, demonstrated that the disease did not depend on the derangement of the structure of any organ. The morbid changes which may have been found in other dissections, must have arisen from the long continued morbid action upon particular parts, forwarded, probably, in some instances, by a favourable pre-disposition, especially that connected with scrofula. The circumstance of three brothers having the disease, thews some pre-disposition, which may be hereditary. The effects of various vegetable substances on the urine will improve the practice. The observation that the urine had been voided in an acid date, corresponds with what has been mentioned in Mr. Houston's case, and by Doctor Cleghorn. This, with several other cases, shows the pre-disposition in diabetic patients to inflammatory diseases. The failure of tonic and astringent remedies, with the effects of vegetable food, and the successful administration of opposite means, confirm the opinion that this peculiar disease is accompanied with a state of constitution very different from that in scurvy. In this case, the patient had an attack of pleurisy, in the month of March preceding that of July, which proved fatal. As active diseases of this nature have been found to suspend the Diabetes Mellitus, the intervening circumstances which occurred in it, between the two attacks of the pleurisy, might somewhat have depended on the sequel of the first, as it was the opinion of Mr. Thomas, part of the diseased appearance of the right lung, with the effusion in the chest, was the effect of that attack.