OBSERVATION LI. MRG, 47 years old, from Terra di Lavoro, a habitual amylivore, with an adipose constitution, himself noticed polyuria in 1871, and a few months later progress in weight loss and weakness: for that, and for unquenchable thirst, with continual dryness and ar- teness of the mouth, and above all for sexual debilitation, he had recourse to his doctor, the distinguished doctor Leonardo Bian- (1) In Barth, Gazzetta di medicina e di scienze naturali, di Malta, di GAVINO Gulía, Anno II, Nov, 15 and 16. Malta 22 luglio 1873. (2) In Barth, loc. cit. and all the diabetic symptoms were gone; since then he has been doing well. This observation has already been published by Dr. P. Sammut (2). chi. In April 1873 the urine, about 7 liters per day, had the specific weight of 1035, with 130 gr. of sugar per liter, about 900 gr. per day. After a cure almost exclusively meat, with tolerance of a few berberages, a little butter, a little red wine, which was prescribed to him by Doctor Bianchi, the patient improved extraordinarily quickly, so that ' after eight days, he emitted only 2 liters of urine, with 70 g. of sugar per liter, 140 gr. about sugar per day; after five more days, he emitted only a liter and a half of urine, with 49 g. of sugar per liter. Consulted on May 4, I insisted that the cure became rigorous, I prohibited butter, vegetables and wine, granted by the transaction of Doctor Bianchi: after fifteen days, the sugar completely disappeared from the urine, the volume of which fell to 700 cc, the patient regained his strength and has been doing well until this day (September 1874), where I have received news from him: for more than a year, he returned to mixed feeding. 

OBSERVATION LII. - M. Guiseppe Durini, 47 years old, from Bolognana (Chieti) (1) very fat in 1866, usually eating large quantities of flour, fruits and sweets, began little by little, without any known cause, and especially without having experienced any moral emotion, to lose weight; in the last seven months he became extraordinarily emaciated: at first, this symptom was attributed to diarrhea which had occurred in the meantime. Finally he showed himself to Doctor Colombo de Nicola, who noticed polyphagia, polyuria, polydipsia, vision impairment and impotence, suspected diabetes and confirmed this suspicion by urine analysis. On January 2, 1874, the patient emitted 5 liters of urine in twenty-four hours, with 65 gr. of sugar per liter, which makes 325 gr. of sugar per day; after eight days of rigorous treatment, Primavera observed the complete disappearance of sugar. The patient continued to be perfectly well; he returned to see me on April 7, 1874, comforted, flourishing in appearance, perfectly healthy, ruddy in color, with greatly improved eyesight. I allowed her the pastures, the wine, the coffee (without sugar), some unsweetened fruits. I saw him again in the best state of health on May 17, 1874: his urine was completely free of sugar, weighed 1022, because it was rich in urea by the fact of (1) He himself wanted to be named here, meat diet; I then allowed him the starchy foods: at the last I heard he was still doing very well, and feeling stronger than ever. 

OBSERVATION LIII. - Doctor G., a very distinguished doctor and director of a hospital in one of the most important towns of Campania, about 50 years old, of fat constitution, lover of starches, contracted diabetes mellitus in 1871, presenting the usual symptoms, with weight loss and considerable weakness. Having learned of the happy results that I had since obtained at my Clinic, which a young student of his parents attended, he submitted to my treatment, and followed it with great rigor. He recovered completely, and used a mixed diet for a long time: today he has gained weight again, he is flourishing in health, and a few weeks ago (August 1874), I saw him in consultation for one of his patients (1). 

OBSERVATION LIV. Doctor Pasquale M., distinguished doctor from Salerno, about 60 years old, of normal constitution, extremely amylivorous, suffering from diabetes for two years, with all the ordinary symptoms; so emaciated and weakened that it was difficult for him to continue his visits, and a little frightened also by the sight of the progress of the diabetes in the dean and the most renowned of the doctors of Salerno, Doctor Centola (who never did the treatment of rigorous meat diet, wasting his time taking arsenic, strychnine, and following the Bouchardat diet), Doctor PM submitted to my treatment, followed it rigorously, and recovered completely; therefore, fully recovered in possession of his strength and with normal urine, although he had returned to mixed food for about a year, I saw him again a few months ago (in March 1874 ), in a consultation in Salerno, which he attended as an attending physician. 

OBSERVATION LV. - Dr. Guiseppe B., from Randazzo, who usually ate a lot of starchy foods, ill, according to what he wrote to me, for three and a half years, is now fully recovered: his urine are normal in specific weight, free from sugar, although, for several months, (1) Special considerations, and the wishes of this distinguished colleague himself, require me to suppress the other details: it is the same for the following cases. he returned to a mixed diet about a year ago. I saw him again a few months ago (in March 1874), in a consultation in Salerno, which he attended as an attending physician, he returned to mixed feeding. On February 26, 1874, this distinguished colleague wrote to me that having interrupted the rigorous treatment too early, he relapsed four times, so much so that he began to regard my treatment as a palliative which suppressed, but did not cure diabetes; but after having followed it for a sufficient time, he was able to return to a mixed diet without seeing the sugar reappear in the urine: he then reconsidered his previous opinion. 

OBSERVATION LVI. MF Saverio M., from Borgia (Cantanzaro), 53 years old. At the age of 40 he experienced, as a result of serious sorrows, sufferings in his stomach and intestines, with diarrhea: but he recovered completely, got married at 14, had children and did well until the age of 49. At this age, and with no known cause (apart from the daily abuse of mealy seeds), he began to present the first symptoms of diabetes, which he recognized in him a year later by Doctor Cirillo, who prescribed him a treatment which was followed for two and a half months , and which consisted of a diet composed mainly of meat, eggs and milk, with limitation for the use of flour, all accompanied by a prescription of cinchona, strychnine, rhubarb and baking soda. A great improvement followed, but hardly the cure ceased, the patient relapsed and more seriously than the first time. So Doctor Cirillo prescribed a more rigorous treatment, ours, forbidding the use of fruits, milk, vegetables and flour, and adding lactic acid to the previous drugs. The patient got better again, but as he was not sufficiently rigorous in his diet, he presented on January 27, 1874, when I was consulted, 30 gr. of sugar per liter, with a polyuria of 2 to 3 liters per day, and the specific weight of 1023. Subject to my rigorous treatment, the urine, examined on February 15 by Professor Primavera, had the specific weight of 1015 and was completely free of sugar; they were still similar on April 27, 1874. The patient continues to be well, although he has resumed the moderate use of flour. 

OBSERVATION LVII. - Mr. Giacamo F., 33 years old, from Tunis (Africa), client of Doctor Quintilio Mugnaini. He had two brothers who died of diabetes, the second from phthisis after consulting the best doctors in the largest cities in Italy, the rigor of my cure. The patient himself, as his brothers had done, ate almost exclusively on flour and very fond of sweets; he never had moral emotions. In September 1873, he noticed that he had a slight polyuria, that he got up three times at night to urinate, while before that he always slept through the night. The example of his brothers made him seek advice from his doctor, Doctor Quintilio Mugnaini, who analyzed the urine with the help of the pharmacist Sinigaglia, and finding them sweet, diagnosed diabetes, and submitted the patient to my cure. After three days, the urine was free of sugar; after ten days, he ate a little bread, and the urine picked up a little sugar, but with a much less clear reaction than the first time: this sugar disappeared again after a more careful treatment of two months. After forty-five days the patient returned to a varied diet, for he was feeling quite well, and his nutrition was good. On February 25, 1874, he came to Naples, and wanted to consult me: his urine, examined by Professor Primavera, was free of sugar. This case is very interesting because it demonstrates, not only that diabetes is often a family disease, thus affirming its constitutional character, but also, by the sad antecedents of the two brothers, neither long enough nor rigorously enough. treated, that the third brother followed the same route and succumbed, if he had not been saved by coming in time to be treated and to follow the treatment exactly. He also demonstrates that there are not two kinds of diabetes, one curable, the other incurable: curability depends on the degree reached by the disease, on the period at which the disease is recognized, and the patient subjected to rigorous treatment. 

OBSERVATION LVIII. Mr. Carlo de S., 44 years old, military employee on the island of San Stefano. As a result of a great abuse of starchy substances, for he seldom ate meat, and without any other known cause, he suffered from diabetes; for some time he kept his illness concealed, although he suffered from polyuria, with thirst, impotence, great emaciation and extreme weakness. In June 1873, the presence of sugar was found in the urine, and he followed a treatment, but not with sufficient rigor: he ate almost exclusively meat, bis. The sugar gradually disappeared from the urine, and the treatment continued for five months. The urine remained free of sugar, and the patient recovered, assumed a flourishing appearance, and felt robust and strong. Having returned then to abuse flour and to abandon the meat almost completely, after a month we found sugar in the urine, but in small quantities. Professor Primavera, on March 1, 1874, found only 5 gr. of sugar per liter in urine emitted on an empty stomach at 11 am; the urine presented this interesting thing, that it was rare in the morning, but very abundant after the meal, during which he consumed so much flour. The urine, after the meal, contained up to 50 gr. of sugar per thousand. It is a kind of intermittent diabetes depend on the diet, such as starting diabetes. On March 23 began my rigorous cure, and shortly after the urine was completely free of sugar. In June 1874 he was still doing perfectly well, although he returned to a mixed diet after only a month of rigorous treatment. 

OBSERVATION LIX. Mr. Nicolangelo S., 53 years old, from Forino (Avellino). Diabetic since August 1873, by abuse of flour and without other known cause, he also presented a symptom of beginning diabetes, that of the intermittence of diabetic phenomena (polyuria, thirst and sugar in the urine, only after meals, usually rich in starch; in the morning urine is normal and completely free of sugar). - Come to Naples to consult me, he presented me, on January 3, 1874, urine emitted after meals, and whose specific weight was 1034, with 60 gr. of sugar per liter: he immediately submitted to my rigorous cure; from January 22 the urine was sugar free, and weighed 1018: the same on February 23. The severe cure was only continued for a short time: nevertheless, according to the news received, he is still doing perfectly today, although he makes moderate use of the mixed diet. 

OBSERVATION LX. Mr. Aniello S., lawyer, 47 years old, from Carbonara de Nola. Recognized diabetic by Doctor Mele in Ayril 1872; after 2 days of rigorous treatment, his urine no longer contained sugar; he continued thus for a month only, and then was very well, although he ate everything; however relying too much on his regained health, then he abused for a long time flour, sweets and wine, so that again contained sugar; however, the patient was subjectively well. He resumed the cure in January 1873, for 40 days; his urine got rid of the sugar, and he was well, although he ate everything. But in the carnival of 1874, returning to the abuse of sweets, he began to urinate more, and felt his virile power go away: the urine examined contained sugar: here is therefore a relapse after 13 months of well- be and mixed diet, brought about by the abuse of sugary foods. On March 7, 1874, the urine examined by Professor Primavera showed the weight of 1035 with 70 gr. of sugar per liter: but there was no polyuria yet. The cure resumed, the sugar soon disappeared, and the patient regained virile power. - He continues to do well, to what Dr Mele assured me in September 1874. - What is remarkable in this case is that it shows that an individual, who has once contracted diabetes, should not never again abuse the sweets, which are even more perilous and harmful than the mealy ones themselves. This case also teaches that there is no need for trauma or moral suffering to reproduce diabetes: the abuse of hydrocarbons is enough.