d continued. No symptoms of acidosis. The ammonia ran from 0.3 to
1.0 grams per day.

Weight at entrance, 160 pounds.
Weight after three weeks' treatment, 156.
Maximum caloric intake, 2525.

* * * * *

Case 7. A young man of 25, diabetic for eight months, entered Jan. 20,
1915, with 6.6% (112 grams) of sugar and strongly positive tests for
acetone and diacetic acid. After a period of two starvation days he
was sugar-free and actually gained three pounds in the process of
starvation (probably due to water retention).

His diet was then raised as follows:--

Jan. 24.
Carbohydrate, 15 grams.
Protein, 25 grams.
Fat, 150 grams. No glycosuria.

Jan. 26.
Carbohydrate, 20 grams.
Protein, 35 grams.
Fat, 175 grams. No glycosuria.

Jan. 29.
Carbohydrate, 20 grams.
Protein, 45 grams.
Fat, 200 grams. No glycosuria.

Jan. 31.
Carbohydrate, 30 grams.
Protein, 45 grams.
Fat, 200 grams. No glycosuria.

At entrance his ammonia was 1.7 grams per day; after the starvation
days it ran from 0.9 grams to 0.3 grams per day. The acetone was a
little stronger than at entrance; the diacetic absent except on three
days.

On Feb. 5 he was still sugar-free having been so since his starvation
days two weeks previously, and weighed 127 pounds, a gain of seven
pounds since entrance. At no time did he receive over 2150 calories.

This was a very satisfactory case; no doubt the carbohydrate could
have been raised to 50 or 60 grams, but he was doing so well that we
felt it unwise to go any further.

* * * * *

Diabetes in children is likely to be a good deal more severe than it
is in adults. Still, in the few cases that have been treated with the
starvation treatment at the Children's Hospital, the results have been
very satisfactory, as far as rendering the patient sugar-free is
concerned. Most diabetic children, however, are thin and frail, and
they have no extra weight to lose, so it does not seem so desirable to
bring about any very great loss of weight, which is quite an essential
part of the treatment for most adults. The few children that have been
treated have borne starvation remarkably well. It is too early, and we
have seen too few children treated by this method, to say what
influence it may have on the course of the disease, but it can
certainly be said that it is very efficacious in rendering them
sugar-free.

*