Abstract
THE depth of the tragedy into which the most recent investigators of the disease “diabetes mellitus,” whose observations are described in the memoir referred to below, have inquired, is sufficiently indicated by the fact that seven of their ten “severe cases” have died since coming under observation in the early part of 1908. Diabetes is considered as being primarily a disturbance of nutrition tending to develop a condition of starvation, and yet it will be noted that in six of these cases the fatal result is attributed to “diabetic coma.” Diabetic coma is in no sense due to any deprivation of nutriment experienced by the central nervous system, but rather to a very real poisoning assignable to an appearance in the blooct of unusual chemical compounds or to an appearance of compounds in an unusual quantity which are normally present only in minute traces. Nutrition, in short, is not only deficient, leading to a great emaciation of the patient, but is also disordered, leading to death by internally developed poisons. Medical treatment of this disease, its causation having been fully developed prior to the arrival of the doctor, is therefore directed to maintain nutrition in very adverse circumstances by expert adjustments in the diet, and to secure the elimination, or at least neutralise, the effects due to the presence of these poisons. As a valuable contribution to our knowledge of the principles underlying such treatment, this account of the extremely precise and varied observations of Benedict and Joslin will meet with a wide welcome.
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References
"Metabolism in Diabetes Mellitus". By F. G. Benedict and E. P. Joslin . Pp. vi+234. (Washington, U.S.A.: Carnegie Institution, 1910.)
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MACDONALD, J. Metabolism in Diabetes Mellitus 1 . Nature 85, 455–456 (1911). https://doi.org/10.1038/085455b0
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DOI: https://doi.org/10.1038/085455b0