Diabetes, mellitus and insipidus / by Andrew H. Smith.

  • Smith Andrew H. (Andrew Heermance), 1837-1910.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Diabetes, mellitus and insipidus / by Andrew H. Smith. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    36/86 (page 28)
    occasion glycosuria, and the diagnosis of obscure brain lesions may sometimes be facilitated by an ex- amination of the urine for sugar. Bruises and injuries accompanied by mechanical shock, as well as injury to large nerves, are some- times the apparent cause of consecutive diabetes. But in all these cases in which a direct involve- ment of the diabetic centre cannot be predicated, there remains the mental influence which a grave accident, with the fright and excitement accompanying, it must produce, and it is quite possible that this may have more to do with the result than the physical injury sustained. Malaria is apparently the starting point in some cases of diabetes. The causal connection in this in- stance is not difficult to trace. The congestion of the liver which accompanies malaria may very readily interfere with the regulation of the glycogenic func- tion; and clinically it is found that hepatic conges- tion from what ever cause, is accompanied in a large proportion of cases by glycosuria. For example, in a case observed by the writer at the Presbyterian Hospital, in which the menstrual epoch was regularly marked by great enlargement of the liver, the urine contained sugar on each occasion when the conges- tion was at its height. The predisposition existing, it would only require a long continuance of the disturbance of the liver to convert temporary glycosuria into permanent dia- betes, and this might be effected by chronic malaria.