se of
young persons, in whom its progress is apt to be rapid. The
complications of the disease are many and serious. It may cause impaired
vision by weakening the muscles of accommodation, or by lessening the
sensitiveness of the retina to light. Also cataract is very common. Skin
affections of all kinds may occur and prove very intractable. Boils,
carbuncles, cellulitis and gangrene are all apt to occur as life
advances, though gangrene is much more frequent in men than in women.
Diabetics are especially liable to phthisis and pneumonia, and gangrene
of the lungs may set in if the patient survives the crisis in the latter
disease. Digestive troubles of all kinds, kidney diseases and heart
failure due to fatty heart are all of common occurrence. Also patients
seem curiously susceptible to the poison of enteric fever, though the
attack usually runs a mild course. The sugar temporarily disappears
during the fever. But the most serious complication of all is known as
diabetic coma, which is very commonly the final cause of death. The
onset is often insidious, but may be indicated by loss of appetite, a
rapid fall in the quantity of both urine and sugar, and by either
constipation or diarrhoea. More rarely there is most acute abdominal
pain. At first the condition is rather that of collapse than true coma,
though later the patient is absolutely comatose. The patient suffers
from a peculiar kind of dyspnoea, and the breath and skin have a sweet
ethereal odour. The condition may last from twenty-four hours to three
days, but is almost invariably the precursor of death.

Diabetes is a very fatal form of disease, recovery being exceedingly
rare. Over 50% die of coma, another 25% of phthisis or pneumonia, and
the remainder of Bright's disease, cerebral haemorrhage, gangrene, &c.
The most favourable cases are those in which the patient is advanced in
years, those in which it is associated with obesity or gout, and where
the social conditions are favourable. A few cures have been recorded in
which the disease supervened after some acute illness. The unfavourable
cases are those in which there is a family history of the disease and in
which the patient is young. Nevertheless much may be done by appropriate
treatment to mitigate the severity of the symptoms and to prolong life.

There are two distinct lines of treatment, that of diet and that of
drugs, but each must be modified and determined entirely by the
idiosyncrasy of the pat