strain and loss; and in the face of such facts what is clearly our duty as men of progress and reform? If a cigar-after the evening business allows us, at our own fireside, say at ten o'clockwill stimulate us to mental feats an hour or two later; or if we depend upon stimulation with wine or beer to aid us in any mental pursuit, we are blindly pursuing a course calculated to wear us at fearful expense, whenever or however taken, and will, circumstances being equal, and in the majority of cases shorten life. If we lash the stomach to unusual feats, or keep the brain muddled past realizing our true state, what else can we expect but shattered force as a result?

The abomination of the course pursued at many fashionable banquets given where courses of wine are furn.shed with courses of food is a puny, sickly mockery, an aid to crime and criminals, because it is the very way to blunt the finer feelings. It would be an innovation on custom to do differently, I admit; and custom rules the world of fashion, folly and pride-not sense, sober cultivation or thought. May we not bless mankind by doing our duty in this direction? and so earnestly and so constantly proclaim the evil of tobacco and alcoholic beverages, together with all excesses and irregularities, that we may at least save portions of the future generations for models of physical excellence.

Wine may have a place as a remedial means in sickness, so may opium and morphia; but heaven forgive the doctor who prescribes either without good grounds and knowing to whom he is administering, for if the habit fastens upon the invalid great blame rests solely with the prescriber; the drinking of the one or taking of the other by debilitated invalids day in and out is a grave mistake.

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When," says another quotation, “we look about us and consider the present physical life of man we are obliged to conclude that the whole head is sick and the whole heart is faint. If we as a people, could cease at once bad breathing, bad eating, bad reading, tobacco, all beverages as such, opiates and artificial life generally, we would rise above our present condition, the demand for yellow-covered literature would abate, and so would lawlessness and crime." In conclusion, I ask the members of the Eclectic brotherhood in the United States, and especially of our Association, in view of our position as reformers, what is our duty, and will we do it?

DIABETES.

BY JOHN V. LEWIS, M.D., ALLIANCE, OHIO.

Elaborate pathographies of the disease under consideration may be found in the standard medical works of the day, so that though the nature of the disorder is not satisfactorily understood, sufficient is known to render the diagnosis of the complaint comparatively easy, the pathognomonic symptom being an increased renal excretion, "containing an abundance of sugar." This condition of the urine is admitted to be the diagnostic criterion by the most distinguished authorities.

But when we endeavor to ascertain the cause of the complaint we encounter difficulties that up to the present time have been absolutely insuperable.

Many investigators have disported in the field of conjecture, and, by the play of their imaginations, have traversed the entire domain of speculation in inventing plausible theories of the cause of the disorder, only to witness them disappear as the "baseless fabric of a dream." Others have sought, by patient and indefatigable investigation, to determine the origin of the complaint, and while they have not wholly accomplished their object, have cast much light on the pathology of this intractable disease; so that we may indulge the hope that ere long the nature of the malady may be satisfactorily determined.

Bernard, with his "hepatic-dextrine and blood-ferment dependent on morbid excitation of the nervous system," believed that he had discovered the cause of the complaint; but Dr. Pavey was led by experiments to oppose this theory. Dr. Prout has attempted to mask the ignorance of the profession on the subject, by declaring that the disease is controlled by "hereditary law."

Others believe that it is excited by exposure to wet and cold, sudden changes of temperature, intemperance, as well as by debilitating habits of life. But as is evident from the conflicting opinions of these distinguished physiologists, the cause is yet to be discovered. Therefore, it may not be presumptuous to add another theory to the list of conjectures already given. Adopting the views held by Dr. Prout, as to hereditary law controlling the disorder, together with the assumption that it is always the result of a lesion of the nervous system, we may hope that we are pur

suing a line of investigation that will ultimately unravel the mystery which envelops the pathology of the disorder, and thereby be enabled to successfully treat the disease.

Briefly let us consider the untenableness of the doctrine that exposure to wet and cold, &c., may be the cause of this disease other than by exciting a peculiar morbid condition of the mucous system, which, in turn, may become the exciting cause of the complaint.

Among a dozen persons exposed to wet and cold, one only may become afflicted with diabetes. The others bear the exposure with impunity without suffering from the disease. Again, we may select two individuals afflicted with disordered digestion, and diseased liver, alike in both cases so far as we are able to determine by all the means at our command. The one may also be afflicted with diabetes, the other is wholly exempt from this malady. Now, we do not avow that these facts are conclusive evidence that the disease is not produced by exposure to wet and cold, independently of the pernicious effect that such exposure, &c., would have on the nervous system; but we believe that they afford good ground upon which to predicate the opinion that the disorder is a lesion of the nervous system whereby its power to control the vegetative functions is impaired, and the "balance of the vital economy" destroyed by disturbance of the chemical processes of the system, or other derangements of the vital functions. And the experiments of distinguished physiologists fortify, if they do not confirm, this theory. Dr. Goolden gives several instances of head trouble that were accompanied with saccharine urine, and says that remedies for the head complaint cured the diabetic symptoms. Dr. Pavey witnessed diabetes following a violent blow on the head, and as the head trouble vanished the diabetes disappeared. Bernard said the disorder supervened after a fall on the head. A cure of the injury of the head was followed by complete restoration to health. Erichsen declares that he treated a hospital patient for paralysis, the result of a fall on the back of the head, who was also afflicted with saccharine diabetes. As the paralytic disorder improved diabetic sugar gradually diminished until it disappeared from the urine. The London Medical Record of April 15, 1879, says: "According to Cyr's opinion (Bull: de Therap., December, 1878,) arsenic, phosphorus,

and mercury may cause persistent diabetes. Substances which are more diffusible, such as alcohol, ether, chloroform, even if used for a long time, do not seem often to produce the disease, but if it should come on the author would attribute it to the effect of one of these substances on the nervous system." The same remarks are applicable to the abuse of certain drugs which act especially upon the nervous system, such as opium, strychnia, curare, and also bad beer, or when this disease supervenes in horses which have been fed with wet oats. Carbonic oxide may also cause glycosuria. In the latter part of the article the author speaks of telluric poison as a certain cause, not only of glycosuria but also of diabetes; this latter affection may be attributed directly to glycosuria, and indirectly to the disturbing effect of the telluric poisoning upon the chylopoetic apparatus. And, we may add that the irresistable conclusion of the author's reasoning and experimentation is, that these agents produce diabetes by their toxical effect on the nervous system; and that when administered in proper doses, no such deleterious effect ensues. But the fact that such drugs, when given in sufficient quantity to disturb the normal function of the nervous system, do cause diabetes, goes to confirm the theory that the disease is the result of a disorder of the nervous system.

Even Bernard, who holds that the disease is a hyper-production of sugar by the liver, admits that the cause of this hyper-production depends on morbid excitation received through the nervous system. But evidence is wanting to show that any case of diabetes has ever existed in which symptoms of a nervous lesion did not precede, or at least become manifest simultaneous with the other disorders of the body. Nor can it be proved that any disease not accompanied with or caused by a lesion of the nervous system, ever causes diabetes. Therefore, we conclude that, though indigestion and faulty action of the liver, as well as renal and pulmonary disorders may be present with diabetes, they are produced by the nervous lesions that cause the chief malady.

But, again, it may be affirmed that, in so far as developed by successful treatment, the therapeutics of the disease point to a lesion of the nervous system. This fact must certainly strengthen the opinion that the nervous system is at fault in

the disease, if it is not accepted as positive evidence of the cause of the complaint.

Because we are unable to point out after death the changes in the nervous system which constitute the lesion productive of this disorder is no reason that the theory under consideration is untenable. For, is it not an incontrovertible fact that many lesions of the nervous system resulting in death cannot be traced by the scalpel, nor discovered by the microscope? Many constitutional disorders depend upon morbid conditions of the nervous system that, in the light of our present knowledge, are inexplicable. Diabetes belongs to this class. Therefore, we repeat that diabetes is not a liver, a renal nor a stomachic disease, neither is it consecutive on any one or all of these disorders, not directly traceable to impairment of the nervous system. That in this disease there appears to be a hyper-production of sugar in the system, or that sugar is not destroyed or properly transformed in the lungs, we admit; but in either case the chemical processes of the organism are disturbed, as the result of the failure of the nervous system to control them, therefore our treatment, if we adopt a rational thereapeutics, must be addressed to a cure of the lesions of the nervous system, on which the disease depends. The great thirst, which is always present in this disease, must be quenched. Do not inflict the tortures of Tantalus on your patient by withholding water from him. You may make him experience the agonies of Dives, so that he would exchange the remainder of his days for a cup of cold water, without the least favorable effect on the severity of the disorder, as a compensation for the misery inflicted by this inhuman and unscientific treatment. But you may accomplish much good by carefully excluding such articles of food from the diet of the patient as are known to increase the saccharine condition of the urine. Some eminent physicians declare that they have postponed the fatal period for a long time by enforcing careful dietetic rules. But, of course, all we can hope to gain by the most careful restrictions as to regimen is temporary relief; and we will frequently be disappointed in this, for in the grave forms of this disorder the most abstemious diet fails to accomplish any good; at least such is our experience. And, as to the remedial measures to be employed, there is much diversity of opinion, which is not surprising when we consider the different