It is well known that Bouchardat placed great confidence in this, in some shape or other, considering that it supplied the place of. the hydrogen and carbon of the sugar; but, according to my experience, it requires to be given with great caution in those cases in which sugar in the urine depends upon the exaggerated healthy function of the liver; this, I have noticed, generally occurs at the commencement of Diabetes; after a time the irritation, which in such cases causes the disease, subsides and is followed by what Dr. Schiff calls paralysis, and therefore the treatment must be changed.

In those cases even in what is called the "irritative" form of the disease, where the patient has been in the habit of taking stimulants, generally it should be given, but much diluted, and in small quantities. The general health seems to require it or it flags, the spirits become much depressed, and I am sure in most cases less evil arises from giving, than from withholding, the alcohol. Where the disease arises from defective power, which I believe is the most frequent, alcohol in the shape of brandy, dry sherry, such as amontillado, and claret, does good;* indeed I consider the bearing or not bearing stimulants a good diagnostic test of the two classes of Diabetes.

* The Lancet. Nov. 27th, 1869.

As far as diet is concerned, the great principle to be kept in view is to restrict the diet of the patient as little as possible consistent with the patient's welfare, and this for three reasons. 1st. By a diet as varied as possible you reduce to a minimum any probable injurious effect as far as the idiosyncrasies of patients are concerned. 2nd. You act up more to the physiological digestive structure of man midway in formation and complexity between that of herbivorous and carnivorous animals; nature designs his food to be a due mixture of nitro-genized and non-nitrogenised substances, and I need not say the more we are able to act up to such physiological indications the better it is. 3rd. We give more enjoyment to the patient and therefore little temptation to break through the rules laid down.

We must guard against loss of weight and power, and in those cases where a very strict regimen is required we must adopt it cautious-ly and slowly and not continue it too long; the plan above mentioned should be employed.

* Rum is much used in France; I have, however, never tried it.

We come now to the second point in the constitutional treatment, to which I attach the greatest importance, viz. Exercise. It is said in Germany that by well-regulated exercise alone has this disease been cured, and one writer, During of Amsterdam, attributes the benefit from taking Carlsbad water more, or at least as much, to the walking which the patient usually takes, when drinking the water; without going this length I am sure the advantage derived from exercise judiciously employed cannot be over-estimated. I believe, with M. Bouchardat, that it enables the system to utilize sugar that it could not otherwise do, and I am sure it thus enables the patient to be less restricted in his diet than he otherwise would have to be, and only by a diabetic patient can this advantage be duly appreciated. The exercise should be regularly sustained day by day, even in wet weather it should not be intermitted: of course great care should be taken against wet feet, and the shoes or boots ought to be changed in wet weather on returning home; it should never be carried to real fatigue, a feeling that exercise has been taken is the most that should be felt. Ten years ago when I was first siezed with an acute attack of Diabetes, and which threatened soon to end fatally, I became so weak and had so little muscular power that I could not walk 100 yards without great fatigue. The muscles of my legs were so powerless that I fell two or three times, and in going down the slightest slope I had to pay unusual attention to my legs or I was sure to fall. I began to take exercise regularly two or three times a day; wet or fine I took it. Gradually I gained strength so as to be able to walk five or six miles a day without fatigue. I now regularly walk from three to five or six miles a day.

Another case I have lately heard of is that of a gentleman who for two years noticed his mouth constantly dry and the saliva thick and gluey; one day the saliva appeared to him to have a sweetish taste; this immediately made him feel that he was labouring under Diabetes; on examining his urine he found a large quantity of sugar in it: he at once dieted himself, took gluten bread, and an entirely meat diet, with claret and Vichy water. This treatment was continued vigorously for several months; but not procuring any amelioration of his symptoms, he took ordinary bread, gave up Vichy water and took iodide of potassium; still not improving he took arsenic, four drops of liq. arsenicalis twice a day after his principal meals; this he continued for a month, at the end of which time he was no better; the quantity of sugar remained the same, the appetite was almost gone, he was rapidly becoming thinner and during the month he lost 50 lbs. in weight; his feebleness now was very great. He almost abandoned himself to despair. However, as he had hitherto led a sedentary life, he thought he would now change to an active one; at first he was able to walk a very short distance, at the end of two months he could walk about five miles a day; during his walk he began to perspire a little, this gradually increased: he confined his diet to beef and mutton, took ordinary bread, drank a bottle of vin ordinaire in the day and a bottle of Vichy water; he took coffee after each meal but abstained from all alcoholic liquor. His appetite soon improved, his strength returned, and the sugar began to diminish; from this time he gradually improved, and after six months he was well. He now recovered what he had lost in weight, his strength had completely returned and the sugar had entirely disappeared from the urine.