Recent Literature On Diabetes Mellitus and Glycosuria . By Emil Kleen, Ph.D., M.D. pp. 313. Philadelphia: P. Blakiston's Son & Co. 1900

1900 Boston Medical and Surgical Journal  
the same year appeared the second edition of Von Nborden's work, bused on an observation of 353 patients and Williamson's treatise. In 180!) the friends of Kiilz gave to the world the investigations of the lute scientist on 1,100 patients and published (>i)'2 protocols of his eases. These four volumes are standard works and one naturally looks ¡it ¡i new book on diabetes with u critical eye. Does the author present the sum total of the literature in a clearer manner, is the wealth of his
more » ... l greater, or has he been more prolific in original work? Only when one or all of these specifications are fulfilled is ¡i new book justified. Dr. Kleen published the present volume in Swedish in 181)8, and a few months ago its translation into ISnglish was completed. It opens with the following sentence : " Under the name diabetes mellitus ¡ire iucluded different pathologic conditions which, however imperfectly understood, undoubtedly in most cusoss affect this central nervous system, and which are characterized by a faulty metabolism, as a result of which, under ordinary diet, there takes place the excretion in the urine of an-abnormally large amount of sugar." It is only justice to the author and translator to say ¡hat the latter part of the book reads more smoothly. The historical review of the subject contains no reference to Dobson's use of opium in the lust century or to Hollo's genius in pointing out ¡i hundred years ago that vegetable food should be excluded from the diabetic's diet, which should consist of u restricted amount°f animal food ¡md fat. As this is essentially our treatment to-day, Dobson and Rollo deservís credit for t'usir discoveries. There is a good chapter on the geographical distribution of the affection. " Among all people beyond the pale of culture, diabetes is very rare." With ... a inore intense culture . . . we are ¡"»und to find more diabetes mellitus." As to the influence of diet in the etiology, he thinks "it is too rich a diet, both as regards the mixed nutriment and fuore especially ¡is regard' s alcohol, . . . and that the Importance of large quantities of starch and sugar fias been exaggerated . . . laborers on sugar plan« nations show no special disposition to glycosuria." I'he chapter on glycosuria is simply a compilation°f the existing literature, to which the writer con-'diutes but rarely from his own experience. The "uiereiiccs which he points out between simple glyco-SUl'iu ¡md lni],i diabetes are well drawn. On page 74 OOurs the following sentence in reference to the amount ' ' J sugar in the urine : " Higgins and Ogden speak of fr°%(' 0." If the author had read the article of Ilig-Sj ni B and Ogden with even a moderate degree of care, 10 would not have misquoted them and so found it pessary to doubt their statement. They suy nothing ,U)(»ut 20% of sugar in the urine. j, Symptoms and complications occupy more than a '""'th of the book, but the chapter is remarkable by tj absence of statistics from the author's own cases. •\y! '"entions 3 cases of recovery from diabetes. Uni the patients came under observation they showed no sugar, but its presence at un earlier date wus certified by reliable authorities. The first was following influenza. Fight and eight-tenths sugar was found in the urine, but six months later the ingestion of 300 grammes of carbohydrates provoked no glycosuria. The second developed after a violent blow on the forehead, and the urine contained sugar a year and ¡i half after the injury, but six months and two years fitter respectively wus sugar free. The third was ¡i teacher in whose urine 7..r)% sugar had been found, but five months later was able to take 200 grammes of carbohydrates a day without glycosuria. it would be of great interest to know the condition of these patients after tins lapse of a few years. The section closes with an account of 24 cases. We are disappointed again here to find instead of scientific studies simply pleasing narratives of patients. No data are offered regarding the amount of proteids and fats in the patient's diets and only scant records of the carbohydrates. Ammonia and acetone are never qiiuntitufed and B-oxybutyric acid is estimated but once quantitatively in the whole book and then only imperfectly. The amount of urea is but rarely'Stated, and in 3 of the cases there is no
doi:10.1056/nejm190007191430306 fatcat:n2wt5qj6qbfyfp3oyta4kja3dy