Southern Medical and Surgical Journal - Georgia Regents University

;1S54.] Diabetes Mellitus. 59in the urine, when feculent aliments are resumed. Opiates, ifgiven alone, are mere palliatives ; but when conjoined withother remedies, and in moderate doses, so as to act on the skinthey are very valuable. M. Bouchardat sometimes prescribesDover's powder, but prefers the old theriaca before all otherpreparations, without defending the absurd complexity of itscomposition.In severe cases of glucosuria, then, diet, exercise, and flannelclothing constitute the basis of treatment, carbonate of ammoniaand opitates best aid their action. Other remedies havetheir occasional uses, such as iron, tonics, chloride of sodium,and antiscorbutic plants. M. Bouchardat often employsemetics at the commencement, and endeavours to modify thedisturbed functions of the liver by aperients, of which ox-gallwith rhubarb is the best.Circumstances influencing the effects of Treatment.—Foremostamong the favourable indications in a case is the rapidreturn of the urine to a normal state, which may take place infrom 24 to 48 hours after the feculents have been excluded. Therecent date of the affection is another highly favorable circumstance; and because it is so, M. Bouchardat urges testing theurine whenever the slightest suspicion can be held, and for thedetection of relapses, which are frequent and insidious. Otherfavorable circumstances are the retention of considerable embonpoint,the easy circumstances of the patient, and his beingin possession of great perseverance.The unfavorable circumstances are the reverse of the abovebut negligence is;still worse than poverty, as the poor man hassome resources. The treatment of the case is usually ill managedin hospitals, owing to the vitiated air, the absence of exercise.,the sameness of diet, and the insufficiency of the surveillance.The existence of a great appetite is a common andnot unfavorable circumstance, requiring only moderation inits gratification, at meals not too far separated. Want of appetiteis a far more unfavorable sign, which should be activelycombated. M. Bouchardat has found small doses of rhubarb,and exercise in the open air, of advantage. Obstinate constipation,resisting the most varied purgatives, is a bad complication,indicating disease of long duration, which has producedimportant modifications in the condition of the alimentarycanal. Fatty substances, combined with matters which leaveresidue, as spinach and gluten-bread with bran, are here indicated.Cold and damp air is unfavorable to diabetic patientsbut M. Bouchardat has had patients from Algeria, and has notderived advantage from sending others to Italy. M. Bouchardatagrees with Dr, Prout in considering the appearance of ah