free this way, he should be
starved again. A semi-starvation day of 150 grams of vegetables, once
a week, whether or no the urine contains sugar, is of value for the
purpose of keeping well within the margin of safety and of reminding
the patient that he is on a strict diet.

_It is very important for a diabetic to take a considerable amount of
exercise: he can utilize his carbohydrate better, if he does._

If this treatment is to be successful, it is absolutely necessary for
the patient to adhere very strictly to the diets, and to measure out
everything very carefully; the meat especially should be weighed.

It will be noticed that in some cases the calories in the diets do not
tally exactly with the protein, fat and carbohydrate values. The
reason for this is that for the sake of convenience the calories have
been given in round numbers--5 or ten calories one way or the other
makes no difference.

The essential points brought out by Allen's treatment are as follows:

(1) It is not dangerous to starve a diabetic, and two or three days of
starvation almost always make a patient sugar-free, thus saving a good
deal of time, as contrasted with the old treatment of gradually
cutting down the carbohydrate.

(2) It is not desirable for all diabetics to hold their weight. Some
cases may do much better if their weight is reduced ten, fifteen, or
even twenty pounds.

(3) After starvation, the diet must be raised very slowly, to prevent
recurrence of glycosuria.

(4) An excess of protein must be regarded as producing glycosuria and
an excess of fat ketonuria, and the protein and fat intake must be
restricted a good deal more than has usually been the custom in
treating diabetes.

Case Reports.

It is thought worth while, for the sake of illustration, to include a
few case reports. The adults were treated at the Massachusetts General
Hospital, the children at the Children's Hospital.

Two charts are kept for each case: one a food chart, with the amounts
of the different articles of food taken each day, and the protein,
carbohydrate, fat and caloric value figured out for each foodstuff;
the second (see below) a more general chart, which shows graphically
the progress of the case.

The first three are cases which were treated first with the old method
of _gradually_ reducing the carbohydrate intake and could never be
made sugar-free, running from 0.1% to 0.2% of sugar. On the new
treatment they responded prom