Type 2 Diabetes

OBSERVATION LXXI. - Mr. Cesare de S., 54 years old, owner in Catanzaro. Suffering from ardor in the mouth and from polyuria since 1871, took a treatment which was prescribed to him by Professor Villanova, and which consisted in the menu of Bouchardat, with iron and strychnine, and later of l 'Lactic acid; the morbid symptoms diminished following this long-followed treatment; on July 19, 1873, he still offered 30 gr. of sugar per liter of urine, the polyuria was 4 to 5 liters per day and the specific weight 1036. This patient affirmed to have always singularly abused mealy and fruits, but was not reached by diabetes until after the grief he had suffered. caused the death of his wife. He affirms, moreover, with all possible precision, that he did not begin to feel better, to gain in strength and in plumpness, until after having begun the use of lactic acid: he assures us that , with him, the absolute meat diet rather diminished general strength. After he had been subjected to my rigorous cure (in July 1873), the urine quickly got rid of the sugar, and on April 15, 1874, long after the patient had returned to the use of bread and pasta (albeit with a moderation very different from the abuse of the past), the urine had the specific gravity of 1.023, and the sugar was absolutely lacking in it, as Professor Primavera found; their quantity was perfectly normal. I had further excellent news from this patient later. 

OBSERVATION LXXII. - Mr. Guiseppe Ti ..., 46 years old, notary in S. Elia Pianise (province of Molise), client of Doctor Colaviti, consulted me in May 1872; he had recent diabetes, weighing 50 to 60 g. of sugar per liter, and a polyuria of 3 to 4 liters per day. Subjected to my rigorous cure, after four days the urine was free of sugar; he returned, after having strictly followed the meat diet for two months, to a moderately mixed diet, and remained perfectly cured. - In this case, the diabetes had developed without any cause known to the patient, except experienced grief before having diabetes. But he experienced severe colds, and severe grief about two years after being cured of diabetes, and as, as a result, he experienced pain in his lower back and increasing general weakness, with swelling. legs and strong attacks of dyspnea especially during the night, he was afraid of a return of diabetes, and had his urine examined by Professor Primavera on September 18, 1874. The urine was found to be perfectly free from sugar, it weighed 1014, and were loaded with albumin (10 gr. per liter). From this it follows that a man cured of diabetes does not take it again, even after serious grief, provided that he does not abuse hydrocarbons again, even if, by other morbid causes, he has acquired , at that time, another disease. The following case cannot so far be given for a definitive cure; but in any case it deserves to be cited after the cured cases, because a cure (at least transitory) has been obtained in very difficult circumstances, and because, if the patient were prudent and wise, one could even to regard as assured a lasting cure. 

OBSERVATION LXXIII. · Mr. Odoardo G., from Bologna, 22 years old, studying veterinary medicine. He says he suffered from polyarthritis for six months, during his teenage years, and after that he felt a stronger heartbeat. He had measles, smallpox, and intermittent fever. He abused Venus, tobacco and wine. He was very fond of starchy foods, and particularly sweets; of these especially he greatly abused. In September 1873, during the course of a slow disease of which he does not know how to specify the point of departure, he noticed that he was urinating enormously, that he experienced an extraordinary thirst and a great appetite, while he was 'significantly weakened and slimmed down. The analysis then showed the presence in the urine of a large amount of sugar. But already, a year and a half before, he was having fun, he himself said more to play than to calm his thirst, to drink 14 or 15 large glasses of gaseous sugar water; So it seems that the thirst was already increased. It should be noted, however, that four months before realizing his current illness, in about May, he fell while climbing a staircase and violently hit his occipital region: to believe that the disease had started slowly much earlier, especially since the patient, in the month of September, when we noticed the presence of sugar in great proportion in the urine, was already notably weakened and emaciated. On October 3, 1873, he entered one of the most important clinics in Italy. Put on the rigorous diet of the meat diet, the sugar completely disappeared after six days; but after various attempts to return to the ordinary diet, and especially several deviations from his diet, the sugar no longer completely disappeared. He left this clinic for good on January 9: returning to his old habits, he noticed an aggravation in all the symptoms, thirst, general weakness, manly impotence, weight loss. The maximum urine output in 24 hours during his stay in this clinic was, according to him, six liters. Having come to Naples, he was received at our clinic on January 19, 1874, exhibiting extraordinary weight loss, general weakness, virile impotence. In the somewhat asymmetrical thorax, there was a slight difference in the pitch of the sound on percussion, and in the prolongation of the expiratory sound. On the heart, a little enlarged, a very slight pericardial murmur: the spleen is enlarged, the liver is not accessible to touch. No other symptoms, no pain in the chest or the rest of the body, no cough, no feeling of worry; but hunger, thirst, and a lot of sugar in the urine. On January 20, he emitted 3 liters, 460 of urine which contained 100 g. of sugar per liter, i.e. 340 gr. per day; the next day he made 5 liters, 760 with 570 gr. of sugar in 24 hours. On January 23, he was put into treatment. From the first day, the urine was 1440 cc in quantity, with 60 gr. of sugar per liter, or 86 gr., 4 per day. The following days the quantity of urine remained normal, on average from 1 to 2 liters, with a high specific weight, between 1030 and 1034, while the quantity of sugar oscillated between 30 and 35 per thousand, between 40 and 70 gr. per 24 hours. On February 4, the first absolute fast of 24 hours was ordered, during which the sugar disappeared entirely: but it reappeared at a dose of 30 gr. per liter, as soon as the patient ate, even meat only. So they reduced her ration, and gave her a soft drink made with bicarbonate of soda of lactic acid, and 1/2 gr. Of potassium carbonate, in water: after this treatment with a reduction of half in the quantity of meat), the sugar fell on February 12 and 13 to the proportion from 1 to 2 gr. per liter. Some thoughtlessness committed from time to time brought it back to 20 per 1000. As the ration increased, the sugar returned to 30 gr. per liter, but a new fast on February 23 made it disappear again completely: the return to the ordinary ration of meat again made traces of sugar reappear, which increased day by day up to 5, 10 and 15 gr .; note that the highest figure was reached only when the patient smoked in secret; when he did not smoke, the sugar decreased, and stood between 4 and 5 gr. per 1000. These small quantities disappeared definitively on March 19, after the administration of pure potassium carbonate dissolved in water, for four days, at a dose of 4 gr. in 24 hours. Since then, the sugar remained absent, the quantity of urine was normal, and their specific weight oscillated between 1026 and 1014. Note that this patient, on entering the Clinic, weighed naked (with his shirt and underpants, and he was is always weighed with the same clothes): 

January 19, 1874 ....... kil. 49,500 he first continued to lose weight and weighed, - January 21. the 24th the 29th February 2 ... the 4 kil. 48,900 48,600 48,300 48,000 47,500 ”after which it began to resume on February 7th. the 11 the 12 the 13 kil. 48,200 48,600 48,800 49,200 to decrease and descend on February 15 to ........ kil. 48,500 and return on February 20 to ..... . kil. 48,700 and go back down following diarrhea on February 22 to .... kil. 47,200 The weight rose quickly, so much so that it reached on February 23 ... 27 kilos. 47,800 48,800 and remained such for some time, with insignificant oscillations, after a purgation, it descended on March 8 to ...... kil. 47,500 oscillations which are largely understood by the fact that the intestine is more or less full. After the complete disappearance of sugar, the weight of the body gradually increased: we found >>> >> >> on March 19th. April 24 28 April 11. the 13th the 17th the 19th the 27th May 1st. the 5 the 6 the 22 kil. 48,200 48,700 49,300 49,600 49,800 50,100 50,700 51,000 51,700 51,900 52,700 53,100 >>) »» So that since February 22, the day of minimum weight, he had gained in three months of treatment, 5 kil. 900 gr. The temperature always oscillated between 36 and 37 ° C., the pulsations which initially were between 50 and 60, were maintained later between 64 and 72, sometimes going up to 80: the breaths were always between 20 and 24 Minute. 

On May 20, this patient, who as a student had, since April, obtained permission to go out every day, suddenly presented sugar in the urine, 8 gr. per liter and per day. Although the patient affirmed that he had not eaten outside of the clinic, I learned that for several days he had been taking rum, which in Naples always contains a lot of sugar: we are willing to believe that he hadn't eaten anything else. In addition, he was struck with a stone in the chest in the street, and so violent that he was thrown to the ground unconscious, felt pains in the right subclavicular region, a region which had been directly struck: he also had a little fever with sonorous groans with small bubbles. 

On May 21, the sugar had reached 10 gr. per liter, from the 22nd it dropped to 4g., on the 23rd and 24th it was maintained at 3g. to disappear on the 25th and remain absent until the 30th, the day when the patient escaped our supervision For more than 15 days this patient, according to his own confession, made when I presented him to my audience to take leave, was eating fresh beans (!), cherries, other fruits, and drank wine. Despite this the glycosuria had ceased. She had not yet reappeared at the end of July, the patient assured me in a letter, although for 12 days he had eaten not only green vegetables, but also milk, cheese and fruits (among which the sweeter ones, like pears, plums, etc.) and half-flour, beans , fresh peas, and eat them up to two kilograms per day (!). The circumscribed pneumonia had somewhat reduced the patient's weight: from 53kil, 1, maximum weight on May 22, it had gradually dropped to 51kil, 4, on May 28, to rise to 53kil, 2, on June 23. 

In a patient as advanced as this one, I would not have allowed the return to the mixed diet, or even to the Bouchardat menu, before at least six months of rigorous treatment, after the disappearance of the sugar. - If I report this observation among the cases of cure and the last, I must make this reservation that I am in doubt about it: the cure is not final: it is too short a time since he returned to the use of milk and fruit, etc., and then he abuses them again. In any case, this patient has demonstrated that even very advanced diabetes can be cured when the cure is carried out with all its rigor (1). (1) As I correct the proofs, I receive a final note about this patient. In the second half of August, after further abuse of fruit and wine, this patient again noticed sugar in his urine, and by an approximate calculation evaluated it at 5 or 10 grams per liter. He suspended the use of fruit for a single day, and the sugar disappeared. 

At the beginning of October, I received a letter from the father who told me: "For a month the sugar had reappeared following a new abuse of fruit and even bread: we knew afterwards that he had also abused liquors and pills containing vomit nut: he took eight in a single day, whereas he should only take two or three. This gave him a sharp intestinal inflammation, from which he died on September 28 ”. So he died of intestinal inflammation! (Author's note.)

"The patient must be supplied with a diet consisting of nitrogenous food, such as butcher-meat, fish, eggs, and soups. Fat (which does not contribute in the least to the formation of sugar) may be given in all its forms, such as cream, butter, cheese, and oil. 

Spinach, lettuce, and cresses may be freely used, but celery and radishes only sparingly; while potatoes, carrots, parsnips, turnips, peas, French beans, cabbage, Brussels sprouts, cauliflower, brocoli, asparagus, seakale, and fruit of all kinds, both fresh and preserved, should be avoided, with the exception of nuts and almonds."

I do not wish to speak here of the patients whom I am treating at present, although in all these cases there are a great number in the process of perfect recovery, and several patients have already returned for some time to the use of carbohydrates: but enough time has not yet elapsed, and I cannot regard them as fully healed. In addition, there are many cases of diabetes cured by my method, by other doctors: so that today we can count diabetes among the most curable diseases. To pretend that a man cured of diabetes could not get it back, even under the conditions in which he contracted it the first time, would be nonsense: just like to claim that one can no longer contract pneumonia, acute catarrh or rheumatism, when you are cured of a first attack, or several. Just as it would be unwise to claim that it is the same disease which recurs after several years, it would be incorrect to maintain that a man, cured of diabetes for one, two or three years and eating everything, experiences a "Relapse" if they contract the disease again after further abuse of mealy or sweets, and under the influence of debilitating conditions. Should it therefore be that the treatment procured future immunity, and that the patient had acquired impunity with regard to the abuse of starchy foods and fruits? It would really be asking too much of a treatment to require such immunity before declaring it effective. Quinine and mercury are not required as much as they are said to be specific, and which do not always even prevent recurrence of morbid manifestations. I cannot cite here the names of all those of my colleagues from Italy or abroad who have obtained success with my treatment: but it would be necessary to add to the 73 cases published above, 52 other cases cured by others than by me, which would make 125 successes obtained in 4 years (1), a figure not to be despised in (1) I asked Professor Primavera for notes on the cases of diabetes treated by him alone . He replied to me by the following letter, which I publish without comment: 

Naples, January 25, 1874. 

Very honored Professor Cantani, 

You ask me for notes on diabetics which you have not seen, but which I have analyzed urine and disease monitoring. Strictly, I don't and which do a disease previously regarded as incurable. Moreover, this cure has become popular in our southern provinces, where everyone orders it, even pharmacists, priests and former patients. Success is assured provided that the treatment is not started too late, provided that it is followed with all the necessary rigor and for a sufficient time. The high frequency of diabetes in these countries means that its beginnings do not escape attention as easily as it once did, and still happens in countries where diabetes is rarer, and therefore is often recognized too late, if the patient does not watch himself, or if he comes across a doctor who does not pay attention then say the exact number, but I can assure that they are roughly twenty in number: some from outside were treated according to your method by foreign doctors, others treated in the same way by Neapolitan doctors, some finally absolutely wanted to be treated by me, always according to your method, henceforth known to all. 

The first piece of information I must give you is this: I have never seen a single one of these patients not being cured, and if four of them seemed to resist the treatment, it is because they were not following it, not with enough rigor; but warned by me, they did it, and also came to a complete recovery. This fact is certainly very consoling, I do not explain it by the practice of other doctors who have also administered to their patient several therapeutic agents unrelated to your medication, such as a decoction of quina, strychnine, opium and the like; but, on reflection, let me explain it to myself because the diabetics of the civilian clientele, that is to say rich or at least well-off, do not allow their disease to age: on the contrary, the poor diabetics who resort to hospitals when they really cannot take it any longer, must necessarily provide a contingent of incomplete healings. My second piece of information, which I guarantee to be correct, relates to this fact: patients who do not strictly follow the meat diet often emit in their urine, along with a little sugar, lime oxalate; so that the presence of this salt is very useful for me to deny those who claim to adhere strictly to your treatment, and transgress it more or less, by eating a little bread or fruit (often out of ignorance). 

As for the return of diabetes, I have observed several cases of it after eight months and more, up to two years; but I have always seen the sick recovering again with the same treatment. So much so that it can be said, with great probability, if not complete certainty, that any diabetic, once cured by your method, could secure lifelong cure, if he had the patience to repeat the rigorous treatment for two months every semester, and this for a number of years. If I were diabetic this is how I would act, with the firm conviction that I would never die from it. Finally I noted in all these patients, as a constant cause, the usual abuse of flour (bread, pasta in general): only once was this abuse lacking, but there was, on the other hand, abuse of cane sugar (sweets, sorbets, jellies, sweet coffee, etc.). 

G. PRIMAVERA.

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.

My 73 cases of recovery can be divided, from the point of view of a rigorous recovery statistic, into 8 categories: 

1. Category. - Cases cured and remained in good health to this day (September 1874): these are numbers I, V, VI, VIII, XII, XIV, XV, XVI, XVIII, XIX, XXII, XXIII, XXXII, XXXVII, XXXIX , XLII, XLIII, XLV, XLVII, LI, LII, LIII, LIV, LV, LXII, LXIII, LXIV, LXVI, LXVII, LXXII. In all thirty cases. 

2. Category.- Case of diabetes cured, dead, more than a year after returning to mixed food, due to any recurrent disease, without the sugar ever reappearing in the urine. These are numbers IX, X and XI. Three cases. 

3. Category. - Cases of diabetes cured and remained notoriously healthy for a very long time, until the latest news, but not seen for some time. In this category we must classify nos III, VII, XX, XXI, XXIV, XXV, XXVI, XXVIII, XXXI, XXXIII, XXXV, XXXVIII, XL, XLI, XLIV, XLVI, XLVIII, XLIX, L, LVI, LVII, LVIII, LIX, LXI, LXXI. Or twenty-five cases. 

4. Category. - Case of diabetes cured, enough to be able to return to a mixed diet, but having fallen ill again, following a new abuse of flour, pasta and sweets, and cured again by treatment. Nos. IV, XIII, XVII, XXVII, XXX, XXXVI, LX. Or seven cases. 

5. Category. - Case of diabetes cured recently, being able to use moderately flour, fruits and even sweets, without the sugar reappearing in the urine: these are nos LXV, LXVIII, LXIX, LXX. In all four cases. 

6. Category. - Cases of diabetes that have remained intermittent at long intervals, when the patient abuses sweets: Let there be two cases to this point numbers XXIX, XXXIV. The transient intermittence of diabetes was also observed in case XXX after recovery obtained: but here it was followed by the complete return of diabetes with its most terrible phenomena. There is still intermittence in the LVIII case, when the patient, recovery obtained, returns to the use of starchy foods. Finally, it was noted again in the LIX case, and there it came after abuse of the hay-fed, when the patient had taken a meal too loaded with hydrocarbons; it is cured by a return to treatment. In the LVIII and LIX cases, diabetic intermittence was observed with regular intervals, and with a very exact daily type: melituria then depended solely on meals; once the sugar that the organic forces had not been able to transform, it disappeared once again: this was a form of diabetes beginning in which the daily return of meals at the same times leads to a regular return of sugar with the daily type. (Author's note.)

7. Category. Case of diabetes cured, but became ill again a long time later, having returned to an almost exclusively starchy diet, and died as a result of diabetes, for not having resumed treatment. Here we must note case II. So there is only one. 

8. Category. - Case cured for a short time and therefore not yet assured of recovery, then became slightly ill again following a premature abuse of prohibited foods, and finally died, not by the fact of diabetes, but by an intercurrent disease. Here we must cite the case LXXIII. So there is only one.