Lactic ACID IN DIABETES.—Dr. George William Balfour, in a paper read before the Medico-Chirurgical Society of Edin- burgh (L£dinburgh Medical Fournal, December, 1871), calls attention to some observations of Professor Cantani, of Naples, on the use of lactic acid in diabetes, and reports seven cases of this disease in which he has employed it. Prof. Cantani believes that in diabetes the question is not so much one of increased production as of defective combustion of sugar; and this defective combustion, he thinks, depends upon the production of a morbid form of glucose, which he terms para-glucose. This is incapable of being transformed into lactic acid, and therefore cannot be burned, but is passed unchanged in the urine. The consequence is that the heat of the body must be maintained at first by the combustion of the albuminates and fats, and later in the disease by that of the patient’s own tissues. He, in common with many modern pathologists, recognizes the liver as the organ mainly at fault in diabetes ; and his treatment is partly directed towards giving it as complete a rest as possible by depriving it of its pabulum, which is accomplished by subjecting the patient to a rigorous meat- diet, thus reducing to a minimum the introduction into the system of sugar-producing substances, and partly towards ar- resting the waste and ultimate complete degradation of the body, by supplying a combustible agent in a quantity sufficient for the wants of the body, so that the fats may continue to be stored, and the body thus gradually brought back to its normal standard; and he hopes that this restoration of the healthy standard of the constitution, coupled with the prolonged functional rest to the organ affected, may suffice to prevent any relapse into its morbid condition, even after a return to the ordinary dietetic conditions of modern civilized life.

The combustible agent which Cantani has selected is lactic acid; and this he administers in doses of from 70 to 150 grains daily, diluted in from eight to ten fluidounces of water. An exclusive meat-diet is insisted upon; for drink he allows water, either plain or with a little of the purest alcohol ; coffee, tea, and wine being prohibited.

His results have been somewhat surprising. In recent cases the cure is stated to be almost certain, and speedy; and even where an exclusive meat-diet is not persisted in, life is apparently prolonged, and many of the unfavorable results of diabetes are prevented, though the melituria is not arrested. The success which has been claimed for the treatment in which skim-milk is the exclusive article of diet is readily understood when we reflect that milk contains from three to six per cent. of lactin, which, under the influence of the caseous matter, becomes transformed into lactic acid.