First Contact:

gather% / fish % / hunt %
fat % / protein % / carb%

A rough estimate to help us understand how carnivorous and how ketogenic these people were before being exposed to western civilization


Click this Slide deck Gallery to see high quality images of the tribe, daily life, diet, hunting and gathering or recipes

About the Tribe

Importance of Animal Products

Importance of Plants

Transition to Industrialized Food Products

Ketones: The Fourth Fuel

Joseph Priestly carries out an experiment and realizes that life, flame, and air are woven together after noticing that he could isolate oxygen and observe a mouse fainting after a flame consumes the air.

"A few days prior, Priestly had made a curious discovery: He had lit a flame in a large jar, then sealed the container until the flame burned itself out. He then place a mouse in the container and watched as it soon collapsed, apparently due to the lack of air. Had the flame consumed the life-giving gas within the ar? Inspired, Priestly then repeated the same experiment--depleting the air inside the constainer with the candle--but this time, in addition to placing the mouse inside the container, he added a mint plant from the garden, sealed the container quickly before gas could be exchanged with the outside air, and set the container in the sunlight. The mouse regained consciousness. Somehow, the combination of plant and sunlight revitalized the air and infused the mouse with life force. Additionally, he found that the flame would again burn inside the container after the plant had "restored" the air. Life, flame, and air, Priestly realized, were somehow woven together.

For today's experiment he would again use the sun. He magnified the sunlight spilling through the laboratory's only window onto a small amount of a reddish substance known as mercuric oxide. He then used his apparatus to capture the gas that was released as the mercuric oxide began to burn. For the remainder of the day Priestly would perform a series of experiments with the newly isolated gas. He began with the flame. He noticed that it burned with much more intesity when placed inside a container with the new gas. He again filled ethe container with the new gas and sealed the mouse inside. Amazingly, when comparing results to those seen with a container filled with normal air, the mouse stayed conscious four times longer. This new gas, declared Priestly , was "five or six times as good as common air."

"The feeling of it in my lungs was not sensibly different from that of common air, but I fancied that my breast felt peculiarly light and easy for some time afterwards. Who can tell but that in time, this pure air may become a fashionable article in luxury. Hitherto only two mice and myself have had the privilege of breathing it," he wrote, late in the night. 

Lectures to Ladies on Anatomy and Physiology

Mary Gove Nichols, disciple of Graham, taught physiology and anatomy and claimed that God designed humans to eat vegetables.

Mary Gove Nichols was a leading crusader for vegetarianism during the mid 19th century. She was a disciple of Sylvester Graham - perhaps the foremost vegetarian advocate of the century - and as a "Grahamite" her major form of activism was to teach physiology and anatomy to Americans. 

To this end, Gove, who was a physician and proprietor of a water cure establishment (a non drug, "nature cure" facility), presented a series of lectures to female-only audiences eager to learn about the human body and how it functions. At the time, women were not supposed to lecture to audiences including males, but Gove managed to reach them as well through her published lectures, her magazine, and other works. Gove was also a novelist, acknowledged by no less a literary figure than Edgar Allan Poe, whose dying young wife Gove attempted to save from a fatal case of consumption (tuberculosis). 

Gove couldn't save Poe's beloved cousin/wife, but she did help many people regain good health. Women (and men) were interested in what Gove had to teach, because they wanted to take control of their health and the health of their families instead of relying on the often treacherous, sometimes fatal drug medicine prevalent throughout the century. 

Nichols and her lectures were popular. History records that at one lecture, the audience numbered as many as 2,000 - and that lecture was delivered in a small city. Vegetarianism was an integral component of Gove's teachings. Like her mentor Graham, Gove explained that God did not design the human body for flesh eating but to eat of the foods of the vegetable kingdom. 

Gove, like Graham, was not typical of today's vegetarian advocate. It's doubtful that she would have approved of many vegetarian convenience foods, although she probably would have liked those low in fat and high in fiber. One's diet had to be heavy on whole grains, vegetables, and fruits - devoid of coffee, tea, condiments, and grease as well as meat - to pass inspection by her. Gove and other vegetarian crusaders contended that in some cases a diet that included flesh foods might be more wholesome than one that was vegetarian but loaded with grease and pastries. This was a concession evidently born out of compromise, which all but the staunchest vegetarian activists (those motivated primarily by religion or animal rights) seem to have made. Most likely they made this concession because they lived in a virulently meat-hungry and vegetarian-suspicious time that lacked hard scientific evidence proving the benefits of rejecting meat. 

Besides the "vegetable diet," Gove and other "physiologists" called for a long list of daily practices, from bathing and exercise to adequate rest and cheerful attitude, as the prescription for health. If that advice seems familiar, the next time it is mentioned remember Gove, who like Graham, journeyed from city to city preaching physiology and a vegetable diet. Over time, many of the ideas of the American veg pioneers - derived from observation, the Bible, and natural history - have been scientifically verified and adopted by mainstream medicine. Until now, Graham, Gove, and company have rarely received credit for their attempts to aid ailing America. When they have been recognized, they and their groundbreaking work have usually been portrayed more as caricatures than as people of strong character, out to save the sick from unhealthful habits.

Monograph on Cancer

M. Tanchou is of opinion that cancer, like insanity, increases in a direct ratio to the civilization of the country and of the people.

Professor John LeConte (1818-91) received his degree in medicine in 1841 from the College of Physicians and Surgeons in New York and was preparing himself for graduate medical study in France when circumstances changed his plans and he took up instead a general practice in his native Georgia. There he read, in French and British medical journals, summaries of a memoir on cancer which had been submitted by Stanislas Tanchou in 1843 to the Academy of Sciences in Paris. No doubt Le Conte's interest and approval were strengthened through his discovery that the Parisian scientist had independently reached conclusions in regard to malignant disease that were similar to those Le Conte had himself published eight months ahead of Tanchou, in a “Monograph on Cancer” which he read before the Society of Alumni of the College of Physicians and Surgeons of the State of New York on October 18, 1842.

Now from his Savannah address where he was a beginner in the practice of medicine, Le Conte sent to the Southern Medical and Surgical Journal of Augusta, Georgia, to be printed in its issue for May 1846, the paper that introduced the views of Tanchou to the United States: “Statistical Researches on Cancer.” Among the points of agreement between the unpublished Tanchou memoir of 1843 and a published Le Conte paper of 1842, were that (1) cancer, while found in children, is pre-eminently a disease of middle and old age; and that (2) its incidence is greater in cities than in rural districts.

The Tanchou pronouncement, which Le Conte seemingly expected would be startlingly novel to his readers, and in which Le Conte does not claim to have himself preceded Tanchou, is broached first on pages 273-74:

“M. Tanchou is of opinion that cancer, like insanity, increases in a direct ratio to the civilization of the country and of the people. And it is certainly a remarkable circumstance, doubtless in no small degree flattering to the vanity of the French savant, that the average mortality from cancer at Paris during 11 years is about 0.80 per 1,000 living annually while it is only 0.20 per 1,000 in London!!! Estimating the intensity of civilization by these data, it clearly follows that Paris is 4 times more civilized than London!!

“Seriously, however, the greater frequency of carcinoma in France, as compared with England, is a very curious fact.” Le Conte discusses whether differences in registration methods can account for this difference in figures and concludes that there could be some difference; but he decides that “it is totally inadequate to account for the remarkable disparity in the mortality from this cause (cancer) in the two countries.”

Here Le Conte introduces a table, apparently copied from Tanchou, comparing cancer deaths in England and Wales with the French, and concludes that “after making due allowance for the difference in the systems of registration, the mortality from cancer in the department of the Seine is nearly quadruple what it is in England and Wales. Hence it is clear that the general preponderance of the disease on the continent cannot be reasonably ascribed to any diversity in the classification of kindred diseases.”

On page 275 Le Conte asks, “How will we account for the supposed fact that carcinomatous affections are on the increase? To some extent, the augmentation may be only apparent ...” This he considers, and his verdict is that “if this is the true cause of the increase in frequency, it must indeed be co-extensive with the progressive advancement of civilization, unless some countering influences are brought to bear ...”

Memoir on the Frequency of Cancer

Cancer is very old in the civilized world, but rare in the native world based on research by Tanchou

Report of Dr. Philip R. White on his Tanchou Inquiry

On February 13, 1959, Carol and Phil White wrote from Paris. Phil's part of the letter said:

“Yesterday I sent you a packet of papers on the Tanchou affair. Today ... Carol urged me to write a little squib of a different sort [for possible use in a magazine]. I have written one; but clearly it should have your approval, if forthcoming, before being submitted.” It received my approval and I present it here:

“There is probably no more august body of savants in the world than that created by Descartes and Pascal, sanctified by Richelieu and the Roi Soleil, abolished by the French Revolution, rejuvenated by Napoleon; the Académie Française and its associated academies which make up the Institut de France: ‘The Immortals.’ Under the dark dome of the institute, on the Left Bank of the Seine, in the old Palace of the Four Nations, these men meet to ponder the problems of the world ...

“A year ago one of the youngest old men I know, Vilhjalmur Stefansson, arctic explorer, authority on Eskimo life, teetotal carnivore at eighty (he eats only [fat] meat), still exploring new trails, set me on one which has led me a merry chase. The Eskimos seem not to have had cancer under their primitive way of life. Neither do certain South American Indians, so the tale goes. Nor do the natives of Central Africa.

“A century ago a French doctor, Stanislas Tanchou, who had served with Napoleon in Russia and at Waterloo, retired to Paris and private practice after the wars. At the end of a lifetime of experience and study of the statistical distribution of cancer, by peoples, by profession, by sex, age, and habits, Tanchou propounded the theory that cancer was a disease of civilization. Coming to the attention of Californians ... the idea impressed itself upon the minds of doctors and sea captains in the Alaska trade so that the early observations on the Eskimos were more than casual notations; these men were looking for cancer. That they did not find it gives their data added weight.

“But this information in the hands of Arctic ship surgeons was second or third hand. Just what had Tanchou himself said, and what was the basis for his conclusions? My friend Stef wanted to know. And the Surgeon-General's lists, the Archives of the Library of Congress, were rather reticent. A few brief notes but nothing like the extensive papers which the British and American medical journals of the 1840's had ‘reviewed.’ Where were the originals? Perhaps somewhere in Paris, where one can find anything if one looks long enough. I was going for some months to Paris. Would I see what I could find?

“I love a hunt. Starting from the Surgeon-General's list I went first to the Library of the Académie des Sciences. Yes, Tanchou had presented many papers before the Academy, on a variety of subjects; in fact he had three times presented himself as a candidate for election to that body, and three times failed. Among the papers published in the Comptes rendus des séances hebdomadaires were two which dealt with distribution of cancer, presented in 1843 and 1844. I asked to see them. No, these were only brief notes: ‘M. Tanchou summarized as follows. ...’ And no bibliography, no cross references. Perhaps at the library of the École de Médecine? The Surgeon-General listed four papers there by or about Tanchou. One was clearly wrong: it said 1844 but the journal named didn't start publishing until 1847. Another proved to be only an obituary notice. A third was also partly wrong — the journal had twiced changed its name in 100 years — but by persistence we tracked it down, only to find that the particular weekly number which should have contained Tanchou's article was missing from the file. That left only one, an English journal of 1843. Not very promising. But here we were in better luck, for the Lancet appeared to have translated almost literally the missing article from the Gazette des Hôpitaux Civiles et Militaries. But this again was clearly an abbreviated version of a longer paper which Tanchou said he had published elsewhere. Where?

“On a hunch I went back to the Academy and asked if Tanchou might perhaps have filed a manuscript with them, a manuscript which he had hoped to publish but had not done so. Into the archives again, this time not just to their index but into the actual files for 1840 to 1845. There were many items; twenty-two case histories gleaned from the literature of the world, drawings of operations for cancer of the breast, notes on dissolving bladder stones without operation and, ah, yes, two of interest. One was a twenty-page manuscript which appeared to be, in fact, what I was looking for, though upon closer study it proved disappointing, adding nothing essential to the material in the shorter summaries. The other, however was intriguing. It was simply a notation: ‘Tanchou, deposited June 5, 1843, a sealed packet.’ That was all.

“Early in its existence the Academy took upon itself the responsibility of serving as custodian of ideas, public or private. In the seventeenth and eighteenth centuries in particular, ideas might be dangerous, and since plagiarism was common, even perfectly safe ideas might be hoarded. If a man had such an idea and wanted to establish his right to it without making it public, he could deposit it with the Academy. Thereafter he could, during his lifetime, request the return of his deposition; after his death his heirs could request that it be opened and read but could not have it relinquished to them; and, after 100 years, if requested by anyone not an heir, the Academy reserved the right to open such a packet and decide whether its contents should be published, should be destroyed, or should be returned to the archives for another century. In practice they never destroy anything.

“Was this another manuscript? It had been sealed for 116 years, I could at least see it. This required a formal letter ... A letter was dispatched and permission duly granted to ‘examine’ the packet. On my next visit to the Academy the librarian brought it to me. No, this could not be a long manuscript; it was too small, no larger than a letter, probably only a single sheet of paper. But permission to ‘examine’ did not include permission to open ... So I sat down to write a second letter ... Official approval was granted and a date set for the formal opening.

“Such occasions are impressive. The long paneled hall, a central podium for the president and the two secretaries, an oval series of desks with six transverse lines seating the eighty Immortals, benches along the walls for visitors (the sessions are open to the public), to the left, right, and front statues of Molière, Racine, and Corneille, between these, busts of Buffon, Lamartine, Pascal, Chateaubriand, Laplace, and others. The Immortals file in, sign the register, take their places. There is the usual reading of minutes; a paper is presented ... And then the announcement, ‘The Academy has before it a request from an American colleague, M. White, that a sealed packet deposited in 1843 by M. Tanchou, physician to the King, be opened ... Do I hear any objections? If not it will be done ... In that case we will open the packet.’ An officer beckoned to me to step forward ... He broke the seal and with some difficulty opened the brittle folded paper. It contained a second sealed paper. This seal was also broken and a double sheet of paper spread out ... The ink was dim and the writing ancient ... There was a word underscored in the second line, a short word. What was it? ... It was ‘SEXE’! The paper had nothing to do with cancer.

“My search was ended. I am not sure my friend Stefansson will be content with the result ...”

In a way, I am content with the result. Dr. White's search has, for one thing, indicated what sorts of difficulties may have hampered Dr. John Le Conte in a search for the Tanchou memoir which, it is hard to doubt, he must at some time have made — perhaps in the 1880's, with all the dignity of a university president, preparing for his third statement on Tanchou, the one he issued in 1888.

The more formal report from Dr. White was dated February 11, 1959, two days earlier than the one just quoted. It is to the same effect, and concludes: “... Tanchou had a good idea on the effects of civilization ... He should be remembered for having tried to deal with the question on a statistical basis. His idea of the influence of civilization was fruitful in pointing to facts which need to be studied ...”

With the Dead Sea Scrolls throwing unexpected light on the founder of Christianity, with family revelations throwing expected light on the founder of Darwinism — with such portents, the expected or unexpected may happen to throw new light on Tanchou. But it will then probably be too late for use in this book. Therefore I shall summarize and add further bits.

Though Tanchou is now forgotten in his homeland, and though Africa may be fulfilling his prophecies without knowing they are his, it was not always thus.

It was not so in 1850, the year Tanchou died. That year, pages 487-90 of the Revue Médicale Française et Étrangére carry an affectionate, heartbroken, laudatory appraisal by Boys de Loury, secretary general of the Paris Society of Medicine. However, though the memorial praises Tanchou as a soldier and citizen, and is full of admiration for him as a leading and inspiring figure in the domain of medicine, it says of him in relation to cancer only, “Tanchou's researches on the diseases of women stand out particularly, and especially those on cancer.”

The “Memoir on the Frequency of Cancer,” which Tanchou in 1843 “addressed to the Academy of Sciences,” appears to have made the following points, among others:

According to the Hospital Gazette (Civilian and Military) for July 6, 1843, charts show that cancer is much more frequent in Paris proper than in its suburbs: “... [the like] has been noticed in Berlin and in England ... we know that the number of cancer cases is increasing ... this disease seems to be very old in the civilized world. The first example is that of Atossa, daughter of Cyrus and wife of Cambyses, in 521 B.C. ... many cancers have been found among the mummies of Egypt; and M. Homem ... who spent 14 years in the service of Mahomet Ali, never saw cancer among the peasant women but only among the [aristocratic] Turkish women.

“Cancer is like insanity, found most often in the most civilized countries ... in the Orient it has been found more frequent among Christians than Moslems. Fabrice de Hilden believed that cancer appeared more often in the temperate zone than in the other zones. M. Rouzet says that it is very rare in Africa.

“We have gathered information on this last point that leaves no doubt. Dr. Bac, surgeon-in-chief of the Second African Regiment, never found a case in Senegal, where he practiced medicine for six years. Many other health officers of our brave army have told us the same thing. M. Baudens, surgeon-in-chief at Val-de-Grâce, who practiced civilian medicine in Algiers for eight years, said he met only two or three cases. Finally: Dr. Puzin established a civilian hospital in 1835, 10 leagues from the front; out of 10,000 sick whom he examined there was only one cancer case, the breast cancer of a woman.”

So far as it is possible yet to tell from the documents studied, Tanchou's chief material for arriving at his law came from North Africa, and involved a higher observed cancer rate among the dominant French than among the lowly peasants. The main observations Tanchou bolstered with like Asiatic testimonies, and with statistics comparing metropolitan with suburban Paris, and Paris with England and Wales, also Paris with London. In Europe this all seemingly passed without creating emotional flurries.

A treatise on the function of digestion; its disorders, and their treatment by Pavy

Bernard's experiments show how the milky chyle released from the pancreas dissolves the fat into a minutely divided state.

The next office of the pancreatic juice to be spoken of is that connected with the digestion of fat. Eberle, it appears, was the first to announce, which he did as far back as 1834, that the pancreas possessed the power of emulsifying fat. He experimented, however, only with the glandular tissue of the organ, and never obtained its secretion. His annoucement also could not have received much attention, as it is not until after the publication, in 1848, of Bernard's extensive series of experiments, commenced in 1846, of Bernard's extensive series of experiments, commenced in 1846, that hte pancreas is found to be spoken of by physiologists in connection with the digestion of fat. Before Bernard's researches nothing was known about the nature of the pancreatic secretion, and nothing had been shown to connect it with the digestion of fat. Bernard is therefore fairly entitled to the credit of discovering the function of the pancreas now about to be referred to.

It appears that Bernard was led to the prosecution of his researches upon this subject through observing, whilst conducting some experiments for the purpose of comparing the phenomena of digestion in the animal and vegetable feeder, that after the ingestion of fat the lacteals coming from the intestine almost up to the pylorus were found to be injected with milky chyle in the dog, whilst in the rabbit chyle only made its appearance in the lacteals some little distance down. With this, he noticed a corresponding difference in the point of discharge of pancreatic juice into the intestine, and thus was prompted, whilst seeking for an explanation of the phenomenon, to give attention to the pancreas. In this manner he was led to endeavor to collect the pancreatic juice, and, having succeeded in this, to examine its action upon fat.

The effect produced when pancreatic juice is freely shaken with oil or fat is to form a liquid having the appearance of milk. The pancreatic juice emulsifies or brings the fatty body into a minutely divided state; in which it afterwards remains suspended in the liquid in the same manner as is noticed in milk. The minute globules into which the fat has been separated have no disposition again to coalesce and rise and form an oily layer at the surface, as they do when saliva or any ordinary watery liquid may happen to have been used instead. In this state of minute subdivision the fatty matter is found to be adapted for absorption and passage into the lacteals, the effect of its presence in the lacteals being to give to the contents a milky character, which they do not possess when no absorption of fat is going on. 

New York Hygieo-Therapeutic College founded by Dr. Russell Trall

Dr Trall is a leading advocate of vegetarianism in NY

Among the foremost activists opposing the drug therapists and offering another option was New York City's own Russell Trall, M.D., who was also a leading advocate of vegetarianism. Most who denounced medical mayhem and instead employed holistic, drugless, natural medicine were convinced that flesh foods had no place on the menu. (Anyone for bringing back the term "flesh foods"?)

In 1852, Trall founded the New York Hygieo-Therapeutic College, the first medical school to admit women on equal terms with men. Trall was influenced by Sylvester Graham and Isaac Jennings, M.D., who taught that the body is governed by natural laws originating from God and verified by observation.

Trall contended that when these laws were broken, sickness and death could result. A frugivorous diet--as mandated in Genesis and verified as natural for human beings by 19th-century studies of human anatomy--was one of the laws. When illness developed, rather than suppressing symptoms the drugless doctors sought to remove the causes. Once the causes were removed, the body tended to heal itself. Trall maintained that drugs harmed the body; they did not act upon the body but the body acted upon the drugs. For example, a laxative drug seemed to work only because the body rejected it. The drug itself did not cause the bowels to work.

Trained as an allopath, Trall had observed patients who had become well without drug intervention and those who had been made sicker by drugs. He noticed how the body was helped when patients were prescribed rest, "vegetable diets," treatments such as massage and hydrotherapy (the "water cure"), and direction to fill the mind with higher thoughts.

Trall was a sought-after doctor who even lectured at the Smithsonian Institution during the Civil War on behalf of soldiers. The doctor published more than a dozen books, which found an audience hungry to help themselves and to avoid the horrors and the sometimes fatal results of the regular doctors' medicine.

Hygieo-therapeutic Dr. Trall told his students that his practice was not lucrative, and the only reason they should become physicians was that they wanted to help the sick and teach them how to avoid sickness in the future.

Trall's views about medicine led to his vegetarianism and a vice presidency of the American Vegetarian Society. Like other vegetarians of his time, he abhorred cruelty to animals. In the 20th century, Herbert Shelton studied and then expanded Trall's work, which is today known as natural hygiene. Yet more than 100 years after Trall's death, and after billions of tax-payer dollars have been spent on health care, the nation has yet to examine the drugless doctor's ideas seriously.

He was an influential promoter of vegetarianism and was Vice-President of the American Vegetarian Society.[10] Trall's The Hygeian Home Cook-Book published in 1874 is the first known vegan cookbook in America.[11] The book contains recipes "without the employment of milk, sugar, salt, yeast, acids, alkalies, grease, or condiments of any kind."[11] Trall opposed the consumption of alcohol, coffee, meat, tea and the use of salt, sugar, pepper and vinegar.[7] He believed that spices were dangerous to health.[7]

In 1910, physician David Allyn Gorton noted that Trall's diet was "most simple and abstemious, consisting chiefly of Graham bread, hard Graham crackers, fruits, and nuts—two meals a day, without salt."[12]

Fruits and farinacea the proper food of man :
being an attempt to prove, from history, anatomy, physiology, and chemistry, that the original, natural, and best diet of man is derived from the vegetable kingdom /
by John Smith, with notes and illustrations by R.T. Trall, M.D

Mapping disease: John Snow and Cholera

The first usage of epidemiology and public health occurs when John Snow talked to local London residents of a cholera outbreak and determined they were near the Broad Street water pump, which had become infected by choleric sewage.

Event Rich Text

Diabetes mellitus and its dietetic treatment.

Cantani's diabetic patient observations 21 - 30 are shown, all of whow he put on a carnivore diet to cure them. The scale of the diabetes epidemic even in 1870 Italy seems to be due entirely to carbohydrates.

OBSERVATION XXI. - Mr. Antonio G., notary of Ajello del Sabato (Avellino), had suffered for two years from a dry mouth, and for a year from a sharp thirst, with polyuria, increase of the appetite, impotence and perspiration: for three months, very remarkable loss of weight, with general weakness. He is a man with a flaccid temperament, with an adipose tendency, he has already had ten attacks of gout; for the past two years he has been rid of it: he particularly abused floury foods. Recognized as diabetic by Doctor De Capraris of Atripalda on September 12, 1870, he presented himself to me on September 15 with a polyuria of 5 to 6 liters, the specific weight being 1032, and 72 gr. of sugar per liter. Submitted to the cure, and seen again on November 24, 1870, he was doing perfectly well, had gained in strength and in nutrition and presented urine of the weight of 1022, entirely free of sugar. He resumed with impunity the moderate use of flour; I have long lost sight of him. 

OBSERVATION XXII. Canon Vito M., 59 years old, of S. Agata dei Goti, archpriest of T., abused during all his life mealy and fruit; he had been diabetic for eight months, with 8-10 liters of urine per day, severe weight loss, and beginning to darken his eyesight. He came to see me in March 1872. After twenty days of treatment, he no longer presented any sugar: he continued the treatment for a few months, then returned to mixed food. - Even today (September 1874), he is doing perfectly well, eats everything, and as a precaution has adopted the following diet: three days a week, he eats absolutely nothing but meat. 

OBSERVATION XXIII .-- Canon Francesco F., aged 61, episcopal vicar of Malta, ate meat very rarely, ate almost exclusively flour and sweet fruits, and also abused sugar, to the point of almost constantly having a piece of it in your mouth. Since a long time suffering, weakened, emaciated, recognized diabetic for seven months, he came to see me on August 3, 1872, with notable polyuria (3 to 4 liters per day): the urine, with a specific weight of 1032, contained 60 gr. of sugar per liter: subjected to the cure, the urine, after eight days, was free of sugar, and their weight fell to 1018. It gradually returned to the use of starches, without any unfortunate result, and until the last news he continued to enjoy the best health. I had another report about him in June 1874, from his brother who had come to Naples for an illness; I have learned with pleasure that he is doing very well, eats everything, but mealy foods with wise moderation. 

OBSERVATION XXIV. Mr. C. Pietro B., 44 years old, from Malta, a large consumer of flour, of fruit and sugar, for he ate, even at night, candied fruit and candy. Recognized as diabetic for two years, he presented himself to me on July 14, 1872, with 100 gr. of sugar per liter; the specific gravity of his urine was 1041: he had, moreover, a weakness of sight, attributed by Professors Castorani and Del Monte, whom he had consulted successively, to hyperemia of the optic papilla. Submitted to my cure, the urine was free of sugar from July 22, its specific weight reduced to 1025; he then thought he could use milk, but was quickly punished by the reappearance of sugar in the urine at a dose of 6 gr. per liter, with an increase to 1028 of their specific weight: the milk removed, and the rigorous treatment instituted again, the analysis of the urine carried out on August 3, by Professor Primavera, demonstrated that the sugar had disappeared, and that the specific weight had returned to 1025 (weight still high and due to the abundance of urea and urates); this condition persisted for a long time, then the patient was lost to follow-up. 

OBSERVATION XXV. - M. Domenico 2., lawyer, from Oppido (Calabria), 56 years old, of fat constitution, presented himself to me on May 14, 1871. He has never had only intermittent fevers, and has always eaten a lot of starchy foods. Having come to live in a very humid country, he began to experience a torment in his feet and in his hands, and then tautness and contractions in his whole person which his doctors altered to rheumatism. At the same time, he suffered from polyuria which made him fill two or three vases a day. The demonstration that the sugar had disappeared, and that the specific weight had returned to 1025 (weight still high and due to the abundance of urea and urates); this condition persisted for a long time, then the patient was lost to follow-up. May 16 his urine showed 100 gr. of sugar per liter: submitted to the treatment, on May 19 the sugar was hardly appreciable: this patient having experienced a little diarrhea and some visceral pains, one had to order opium and gum at that time. He later resumed the cure, and was completely cured of the diabetes, as the news received at the beginning of 1874 confirms to me. 

OBSERVATION XXVI. Mr. Francesco P., from Corato (Bari), owner, aged 44, rarely ate meat, and always in very small quantities: he ate almost exclusively starches, fruits and above all made a very - great abuse of sweets. Sick for three years, with no known cause: impotence, thirst, polyuria up to about 4 liters per day, and, for several months, weakened eyesight; he came to me on July 29, 1872; his urine analyzed by Professor Primavera contained 45 gr. of sugar per liter, and presented a specific weight of 1033. Subjected to the treatment on July 31, the urine was, from August 8, of the specific weight of 1014, and completely deprived of sugar. These urine were therefore very poor in urates. After three months of very rigorous treatment, the patient had two months of a mixed diet, but ate mainly meat: the urine was maintained normal. From December 23, 1872, the patient ate everything, like a healthy man, and yet the urine, examined on January 12 and June 7, 1873 by Professor Primavera, was found completely free of sugar: thus the patient could consider himself cured of diabetes, by this ordeal of eight months of mixed diet followed with impunity: this does not prevent that, fearing his old and pronounced penchant for sweets, I urged him to never return to this fatal habit, which could give him the diabetes a second time, as she had done a first (1). .. (1) I learn, when I am correcting the proofs, that a diabetic from Corato, seen by nioi and by Professor PRIMAVERA, and who, for a year, had been perfectly well, had fallen ill again of diabetes, following a new abuse of flour and sweets, and that, as he had not wanted to immediately return to a rigorous cure, he was reduced to the saddest state. It may be Francesco P., but it could also be M. Mat., From Corato, whom I also treated, but that I did not see again, so that I did not know anything positive about it. (Author's note.)

OBSERVATION XXVII. - M. le Baron D'A., Of Naples, aged 50, a great consumer of flour and frozen candies, suffered, without appreciable cause, for two and a half years, from polyuria, general weakness and incapacity ; for a year the thirst, especially after meals, had been so extraordinary that, to quench it, he usually took three or four ice creams (rich in sugar, as we know), after which he was even more thirsty than before. On July 3, 1872 he had his urine examined by Professor Primavera, and they found 40 gr. of sugar per liter: the specific weight was 1025. Submitted to the cure, his urine presented on July 26, the specific weight of 1017, and was absolutely free of sugar: he has continued to do very well since then. though he returned to ordinary food. In the fall of 1873, as a result of an excessive absorption of flour and frozen candies, the sugar reappeared in the urine, but taken in time, and treated for only a month, health returned, the urine remained free of sugar until March 1874: I have no further information. 

OBSERVATION XXVIII. - Mr. Diego della R., diabetic for two years, who absolutely never ate meat, and who, however subjected to my rigorous treatment, got used to it so well that he digested it perfectly, even without lactic acid. His urine had, on July 18, 1872, for specific weight 1040, and containing 100 gr. of sugar per liter: on August 15, they were starved of sugar, and their specific gravity was 1014. He continued to do well, until to the last news received: but it is already some time ago. 

OBSERVATION XXIX. - Baron Francesco TS, of Nicastro, client of Doctor Staglianò: interesting case especially by the intermittences of his diabetes. This patient was doing well when he put himself on the absolute meat diet, and even when he took only moderate quantities of starchy substances. But when he used it extensively for a few consecutive days, he became melituric again, and suffered from drought, thirst and polyuria. His nutrition, however, was still quite good. He did my treatment, not however with all its rigor, on the advice of Doctor Stagliano, and recovered to the point of doing well for a whole year, eating everything. Finally, however, there was a relapse, and this time more serious, October 15, of sugar per liter. The patient subjected to the cure, the sugar disappeared very quickly, reappeared sometimes for a very short time, as I have since learned, and disappeared again, all this as regulated by the diet. - According to later news received in January 1873, his urine was free of sugar, but he suffered from intermittent fevers with hemoptysis; this last accident was, according to his doctor, dependent on the malarial infection. In September 1874, I knew he was fine. 

OBSERVATION XXX. - Mr. Antonio Tirabelli, from Villarica, owner, aged 35, client of Dr. Domenico Majone, abused flour and sweets, had intermittent fevers, and was exposed to colds: no other cause of diabetes can be found in him. For some time, he suffered from polyuria with thirst, without great hunger, and without impotence. For two months, we had observed, in the urine, the presence of sugar, which, on January 5, 1872, reached 80 gr. per liter. The patient submitted to my treatment, and after only three days the urine was free of sugar. He continued the cure for two months, very rigorous for 25 days, but allowing himself three times the use of chicory: later on he softened it even more. The urine, reexamined on January 31, specifically weighed 1019 and did not contain any sugar: it remained that way, as I was convinced by doing my own qualitative analysis of the urine. The patient was well for more than a year, and looked at himself as completely healed, having gained much in nutrition, strength and good looks. The last information received in 1874, by Doctor Majone, is as follows: the patient felt so well that, relying too much on his recovery, he began to eat sugar in great excess, and especially sugar sweet dishes: he noticed at the same time that, each time he made a similar deviation in diet, thirst and polyuria reappeared: sugar was even observed in the urine. If he resumed the rigorous treatment for a single day, the urine became free of sugar again. But he too often repeated these abuses of sweets, for he very much disliked submitting to this suggestion, and, in a fit of mistrust, he decided that he would run the chance, without following any further treatment: so noticeable, impotence, aphonia and general weakness. This last recurrence lasted four months, during which he continued to abuse sugary foods in this way, to eat them every day for 3 or 4 francs ..... and he made all these deviations, because, having become edematous until groin from weakness of the heart, and also a little from excessive fatigue of the kidneys which caused a slight nephritis with albuminuria, he persuaded himself that he would die fatally from dropsy, even though he would be cured of diabetes. 

Finally, at the insistence of his friends, he resumed the treatment, but not rigorously enough: after two weeks, the sugar, which was very abundant on board, had come down to 30 g. per liter, the edema decreased, the strength returned a little, while the thirst and the quantity of urine were normal, and that manly power had reappeared. On March 9, 1874, he underwent the rigorous treatment which I had prescribed for him again, and after a few days the edema had disappeared entirely. The urine examined on April 27, 1874, by Professor Primavera, was completely free of sugar, but contained a small, though quite evident amount of albumin. However, a serious gastric catarrh had developed with complete inappetence; the alvine evacuations were abundant and discolored, according to his attending physician, which made me suspect that the atrophy of the pancreas and the liver were too advanced, as well as the defect of assimilation and absorption of intestines, resulting in thinning and discoloration of feces. 

In the hope, however, that he was not a primary degeneration of the pancreas and the liver, but an incomplete atrophy of these organs, which could still be remedied, (if it was consecutive to the diabetic exhaustion, which could be oppose an improvement in nutrition), I advised adding to lactic acid and pepsin, already ordered by the attending physician, pancreatic fats; and behold, immediately after their use, the patient began to digest better, the stools improved and nutrition was restored. Dr Majone then wrote to me: “Under the influence of this treatment, the patient has always gotten better and better. After five days, the voice became natural, the forces gradually improved, the pulse became stronger and more frequent, the moral state improved, thirst completely extinguished, because he never drinks outside of meals; appetite has become normal, with desire for various foods, and with this peculiarity remarkable, an instinctive tendency towards broths and towards pancreatic fats, all things he hated at first; the stools are regular in quantity, and even in their necks, although they are not absolutely normal. The urine examined by Professor Primavera on May 18, 1874, had a specific gravity of 1018, and, although it was free from sugar, contained some traces of albumin, with a normal proportion of urea and urates. - This patient is still doing well now, September, 1874. This case is still very important, by its apparent form of intermittent diabetes; the intermittences were related to food. After being cured of diabetes, the patient continued to be well, although making use of a mixed diet, provided that it was not too rich in sugary materials, and his urine remained normal: with each excess of sweetness, the urine became sweet and abundant. The organism could therefore overcome and burn a mediocre quantity of hydrocarbons, but it could not overcome the excess of these, and when it had been, for some time, encumbered with these hydrocarbon elements, it lost tolerance towards them, - and intermittent diabetes reverted to the state of continuous diabetes. This case shows again that one can cure diabetes, by following the treatment long enough and rigorously, and that one can continue it again when one is well; but that we must no longer fall back into the excess of hydrocarbons, and especially sweets; it also shows that, even a very slight case of diabetes may change and become very serious, to the point of threatening life in the near future.

Diabetes Mellitus and its dietetic treatment.

Dr Cantani's observations on his diabetic patients on a carnivore diet continue to produce confidence that it works when rigorously followed, in observations of patients 61-70.

OBSERVATION LXI. - M. Guiseppe d'A., Priest, 56 years old, from Acireale. According to the report of his attending physician, the distinguished doctor Gaetano Vigo, this patient has long abused flour and sweet dishes, and ate a lot while burning little, thanks to his way of life. After the death of his mother, which happened on February 14, 1871, and which grieved him a lot, he began to experience a great dryness of the mouth, with thirst, polyuria, and general prostration of strength: he also noticed that a few drops of urine which had fallen on black cloth, left a viscous white stain there. The chemical examination of the urine was not made until 1872, when the patient consulted Doctor Vigo, who found him notably emaciated, weakened to the point of not being able to take a short walk, and who observed in the urine, the specific weight of 1038, about 120 gr. of sugar per liter. The patient then followed the rigorous treatment prescribed by Doctor Vigo, and the urine became free of sugar; but he did not want to continue it beyond 25 days, and still indulging in the abuse of flour and candy, he soon relapsed into melituria, and more seriously than before. The urine reached the specific weight of 1042. The patient resumed cure, and, encouraged by Doctor Vigo, who understood the culmination of my therapeutic conception in this disease, he followed it this time in all its rigor, during four whole months, during which the weight of his body increased by 4 kilogr. Since August 10, 1872, sugar has not reappeared in the urine, the specific weight of which hovered around 1033, and the patient enjoyed the best health, although he had returned, this time with more moderation, to the use of strawberries. I really enjoyed receiving a letter from Dr Vigo, which expressly confirms my opinion as to the frequency of diabetes in these regions, a frequency which is directly related to poverty, especially since “ starchy or sweet food is almost exclusive, even for the upper class. And very cleverly, Doctor Vigo adds that idleness can greatly contribute to the development of diabetes; I believe that this is very probable, on account of the slowing down which idleness brings about in material renewal, in combustion in general, and, in amylivores, in the combustion of hydrocarbons, or of sugar. 

OBSERVATION LXII. MB, from Trani, client of the brave doctor Nanula, who noted the existence of diabetes in him, with 25 to 30 gr. of sugar per liter: the patient ate mainly starchy foods, and suffered from a notable general weakness, with polyuria and ardent thirst. After fifteen days of treatment, the urine still contained 15 gr. of sugar per liter, but they had decreased in quantity, and the state of strength was better: after a month, the sugar had completely disappeared: the patient remained healthy, regained his strength and was overweight: according to the latest information, he continues to enjoy the best health, although he has returned to diet mixed. 

OBSERVATION LXIII. - MG lawyer, from Trani, 60 years old, amylivore par excellence, was introduced to me as diabetic by Doctor Nanula, about three years ago; great prostration, impotence, thirst and especially troublesome polyuria. The urine contained 30 to 35 gr. of sugar per liter. Subjected to my cure, which he followed rigorously for two months, the urine became free of sugar; he rapidly improved in strength and nutrition, and resumed his pleadings in court with all the ardor of his best years. The urine examined again by the the patient remained healthy, regained his strength and was overweight: according to the latest information he continues to enjoy the best health, although he has returned to mixed food. Doctor Nanula these days are sugar free, although for several months he has been eating everything. 

OBSERVATION LXIV. M. Domenico Castronuovo, doctor from Carbone (Basilicata), 52 years old, almost exclusive amylivore, ill since October 1873, with unusual and increasing weakness of the lower limbs, virile impotence, aridity of the mouth, was recognized as diabelic by the doctor. Maturi, and on his advice began the treatment, rigorous meat diet (accompanied by hydrotherapy). On December 17th, the quantity of urine was reduced almost to normal, and Doctor Maturi observed by repeated analyzes the gradual decrease in sugar. The rigorous treatment was continued until January 30, 1874; after this day, the patient feeling cured returned to the mixed diet, and returned to it a little too abruptly, for he immediately allowed himself the use of bread, pastries, even sweetened coffee - and this above all because of the not very flourishing conditions in which he found himself, and which did not not allowed to maintain any longer the absolutely meaty diet. Nevertheless he was doing well, his strength was increasing: he was completely recovered. Towards the first days of February, he presented to the clinic, where he was received as a further observation of the disease. It was doing very well with the ordinary mixed regime, its temperature oscillating around 36°, 5 C .; with 64 to 68 beats, and 12 to 16 breaths per minute, the urine was kept completely free of sugar, its specific weight varied between 1022 and 1025, and its quantity sometimes exceeded, sometimes was not reaching one liter per 24 hours. On March 5, the patient left the clinic in the best condition. - This patient is cured rather quickly because he began and followed the rigorous cure soon after the onset of diabetes, while this one was still in the period of beginning diabetes. 

OBSERVATION LXV. Luigi B., 31 years old, merchant from Soriano (province of Rome). Suffering from great thirst and polyuria, with hunger and growing general weakness, weakness also of the reproductive organs, he was received at my clinic on March 5, 1874. He never ate only a little meat, but ate mainly flour. , especially abusing sweet pasta; he had neither moral emotions nor wounds: for ten years he had suffered a burning sensation in the epigastrium, which disappeared when several glasses of rum, some belching: these sufferings disappeared with the onset of diabetes. He suffered mental distress, but it was long after the existence of diabetes was discovered. He lost his father to phthisis. - At the clinic, he presented more than two and a half liters of urine within 24 hours; their specific gravity was 1042; they contained 277 grams of sugar per day. On March 10, he was put in treatment, he was given only meat, with lactic acid in water, and alcohol mixed with water, instead of wine: on March 11, he only eliminated 1400 cent. cub. urine, with a specific weight of 1021 and 15 grams of sugar per liter, about 22 grams per day. On March 12, Fehling's solution already indicated the disappearance of the sugar; the quantity of urine was 1970 CC, their specific weight 1015. - The urine remained free of sugar, their quantity oscillating between 1200 and 1700 CC, and their specific weight between 1018 and 1023. The temperature of this patient was maintained throughout his stay in the clinic between 36 °, 2 and 360.5 C .; only once did it rise to 370.9 C. due to a temporary febrile attack: the pulse oscillated between 54 and 74, rarely reaching 70 or 72; breaths were almost always a little frequent, between 20 and 24, without any lung disease. - The patient left the clinic on April 3, in the best state of health and strength: for some time he had returned to a moderate mixed diet.

OBSERVATION LXVI. - Mr. Francesco S., 60 years old, owner in Castellana di Bari, diabetic for a year, following abuse of flour and fruit, stubborn smoker, and gouty, was subjected to the rigorous cure by Doctor Nicola dell'Erba in November 1872. He was then 50 gr. of sugar per liter, with a polyuria of 5 to 6 liters per day; ten days after the start of treatment the urine was normal in quantity and quality, and all diabetic symptoms had disappeared. After a very rigorous cure, prolonged for two months and regularly followed, and a rationally graduated return to mixed food, he was able to return to the use of flour, although in moderation: even today he enjoys better health. 

OBSERVATION LXVII. - Mr. Carmine di F., from Alatri (prov. Of Rome), 54 years old, diabetic by abuse of flour since January 1872, resorted to the treatment of Dr. Raffaele Giorgi, when he suffered from an unquenchable thirst with discolored urine, of sugar (not dosed). Doctor Giorgi, after recognizing the diabetes, submitted the patient to my treatment, absolute meat diet and lactic acid; Only six days later, he examined the urine, he found only a few traces of sugar there: however the patient already felt improved: he was stronger, and no longer experienced the symptoms peculiar to diabetes. After 34 days of very rigorous treatment, the patient no longer being able to submit to such great penance, Doctor Giorgi allowed him to use bread in moderation; the urine remained free of sugar. Seeing him two months later, this patient presented normal urine, and was doing well anyway. From what the doctor wrote to me. Giorgi, in June 1874, the patient continued to do well; her urine remained normal. 

OBSERVATION LXVIII. - MN N., owner in Chieti, 40 years old, major consumer of hydrocarbons. In 1872 he suffered from eczema; in May 1873, he began to experience an extraordinary general prostration, especially a weakness of the lower limbs, with simultaneous emaciation, intense thirst, inextinguishable, and emission of very abundant urine: the morale was also affected, the patient became uneasy. , irascible, which he was not previously. In the first days of July 1873, talking with two distinguished doctors, he made them suspect that it was a question of diabetes mellitus: the urine was examined, and it was found that their specific weight was 1033, that they contained 40 gr. of sugar per liter, and that it was emitted 3 liters per day. Condemned to the meat diet, the sugar completely disappeared in three days, the specific weight of the urine fell to 1020, and from the first day of the treatment their quantity had fallen back to normal. Only the general weakness increased with the meat diet, a fact which is observed in several cases (but not in all) at the beginning of this radical modification in the diet, to give way later to a progressive increase in strengths. The cure was interrupted for ten days, and we saw the quantity of urine increase a second time, the sugar reappearing there, and their specific weight go up to 1030. After that the most rigorous treatment was resumed, and continued for six months: the last three months it is softened with a little grass. The sugar quickly disappeared from the urine again, and after six months of abstinence from all starchy or sweet foods, months without any trace of sugar reappearing in the urine, which, on the contrary, showed itself to be richer than before in uric acid and urates, since the patient had eaten everything. The latest news on this patient was communicated to me by Doctor Paolucci, my clinical coadjutor (I had them in September when I was correcting these tests); they confirm his complete good health, and the absolute absence of sugar in his urine. 

OBSERVATION LXIX. - Monsignor B., bishop of C., 49 years old, ate mainly hydrocarbons, and, without any other known cause, had been ill for some time, suffering from thirst with polyuria, general debilitation and mediocre weight loss, because he was fat before he got sick. His urine showed, in Primavera on January 27, 1874, a specific weight of 1033, an amount of 6 to 7 liters per day, and contained 100 gr. of sugar: 600 to 700 gr. per 24 hours. He submitted to the rigorous treatment, less according to the advice of the doctors, than by his own conviction, for he had been aware of our treatment, and had been able to realize, thanks to his great intelligence, of the nature of the disease and the curative method. At first, he wanted to experiment on himself the value of our treatment, and tried a little bread, after several days of absolute meat diet: but the constant appearance of sugar after each attempt, because this intelligent bishop had learned wonderfully at making use of chemical reagents, decided him to follow the most rigorous regimen for three consecutive months; from March 1 to May 30, for three full months, he followed him without the slightest interruption, with all the rigor I could demand. In June, he began to eat grass, bran bread, and drink wine, always examining the urine, which remained free of sugar; on June 23, they were again examined by Professor Primavera, who found them the specific gravity of 1008 (there was still a polyuria of 3 to 4 liters in 24 hours), but complete absence of sugar. 

OBSERVATION LXX. Canon Giovannandrea G., from Ischitella del Gargano, 67 years old, suffering from mild diabetes as a result of eating too much starch, and which seems to have started in September 1873 or some time before: examined by the professor Fede, who noted the presence of 50 gr. of sugar per liter of urine, he was treated with 5 ayril; from with all the rigor that I could demand. In June, he began to eat grass, bran bread, and drink wine, always examining the urine, which remained free of sugar; on June 23, they were again examined by Professor Primavera, who found them the specific gravity of 1008 (there was still a polyuria of 3 to 4 liters in 24 hours), but complete absence of sugar the first days of May, at the second analysis, the urine was free of sugar. At the end of June, Professor Fede again observed in this patient (whom I also saw in consultation with Fede) the complete absence of sugar, although he had returned for more than a month to the moderate use of sugar and starchy foods.

Diabetes Mellitus and its dietetic treatment.

Cantani describes one of his most serious patients and thinks the rigorous meat-only diet cure would need to be done for 6 months to truly allow a mixed diet thereafter. Observations 71, 72, and the last one 73.

OBSERVATION LXXI. - Mr. Cesare de S., 54 years old, owner in Catanzaro. Suffering from ardor in the mouth and from polyuria since 1871, took a treatment which was prescribed to him by Professor Villanova, and which consisted in the menu of Bouchardat, with iron and strychnine, and later of l 'Lactic acid; the morbid symptoms diminished following this long-followed treatment; on July 19, 1873, he still offered 30 gr. of sugar per liter of urine, the polyuria was 4 to 5 liters per day and the specific weight 1036. This patient affirmed to have always singularly abused mealy and fruits, but was not reached by diabetes until after the grief he had suffered. caused the death of his wife. He affirms, moreover, with all possible precision, that he did not begin to feel better, to gain in strength and in plumpness, until after having begun the use of lactic acid: he assures us that , with him, the absolute meat diet rather diminished general strength. After he had been subjected to my rigorous cure (in July 1873), the urine quickly got rid of the sugar, and on April 15, 1874, long after the patient had returned to the use of bread and pasta (albeit with a moderation very different from the abuse of the past), the urine had the specific gravity of 1.023, and the sugar was absolutely lacking in it, as Professor Primavera found; their quantity was perfectly normal. I had further excellent news from this patient later. 

OBSERVATION LXXII. - Mr. Guiseppe Ti ..., 46 years old, notary in S. Elia Pianise (province of Molise), client of Doctor Colaviti, consulted me in May 1872; he had recent diabetes, weighing 50 to 60 g. of sugar per liter, and a polyuria of 3 to 4 liters per day. Subjected to my rigorous cure, after four days the urine was free of sugar; he returned, after having strictly followed the meat diet for two months, to a moderately mixed diet, and remained perfectly cured. - In this case, the diabetes had developed without any cause known to the patient, except experienced grief before having diabetes. But he experienced severe colds, and severe grief about two years after being cured of diabetes, and as, as a result, he experienced pain in his lower back and increasing general weakness, with swelling. legs and strong attacks of dyspnea especially during the night, he was afraid of a return of diabetes, and had his urine examined by Professor Primavera on September 18, 1874. The urine was found to be perfectly free from sugar, it weighed 1014, and were loaded with albumin (10 gr. per liter). From this it follows that a man cured of diabetes does not take it again, even after serious grief, provided that he does not abuse hydrocarbons again, even if, by other morbid causes, he has acquired , at that time, another disease. The following case cannot so far be given for a definitive cure; but in any case it deserves to be cited after the cured cases, because a cure (at least transitory) has been obtained in very difficult circumstances, and because, if the patient were prudent and wise, one could even to regard as assured a lasting cure. 

OBSERVATION LXXIII. · Mr. Odoardo G., from Bologna, 22 years old, studying veterinary medicine. He says he suffered from polyarthritis for six months, during his teenage years, and after that he felt a stronger heartbeat. He had measles, smallpox, and intermittent fever. He abused Venus, tobacco and wine. He was very fond of starchy foods, and particularly sweets; of these especially he greatly abused. In September 1873, during the course of a slow disease of which he does not know how to specify the point of departure, he noticed that he was urinating enormously, that he experienced an extraordinary thirst and a great appetite, while he was 'significantly weakened and slimmed down. The analysis then showed the presence in the urine of a large amount of sugar. But already, a year and a half before, he was having fun, he himself said more to play than to calm his thirst, to drink 14 or 15 large glasses of gaseous sugar water; So it seems that the thirst was already increased. It should be noted, however, that four months before realizing his current illness, in about May, he fell while climbing a staircase and violently hit his occipital region: to believe that the disease had started slowly much earlier, especially since the patient, in the month of September, when we noticed the presence of sugar in great proportion in the urine, was already notably weakened and emaciated. On October 3, 1873, he entered one of the most important clinics in Italy. Put on the rigorous diet of the meat diet, the sugar completely disappeared after six days; but after various attempts to return to the ordinary diet, and especially several deviations from his diet, the sugar no longer completely disappeared. He left this clinic for good on January 9: returning to his old habits, he noticed an aggravation in all the symptoms, thirst, general weakness, manly impotence, weight loss. The maximum urine output in 24 hours during his stay in this clinic was, according to him, six liters. Having come to Naples, he was received at our clinic on January 19, 1874, exhibiting extraordinary weight loss, general weakness, virile impotence. In the somewhat asymmetrical thorax, there was a slight difference in the pitch of the sound on percussion, and in the prolongation of the expiratory sound. On the heart, a little enlarged, a very slight pericardial murmur: the spleen is enlarged, the liver is not accessible to touch. No other symptoms, no pain in the chest or the rest of the body, no cough, no feeling of worry; but hunger, thirst, and a lot of sugar in the urine. On January 20, he emitted 3 liters, 460 of urine which contained 100 g. of sugar per liter, i.e. 340 gr. per day; the next day he made 5 liters, 760 with 570 gr. of sugar in 24 hours. On January 23, he was put into treatment. From the first day, the urine was 1440 cc in quantity, with 60 gr. of sugar per liter, or 86 gr., 4 per day. The following days the quantity of urine remained normal, on average from 1 to 2 liters, with a high specific weight, between 1030 and 1034, while the quantity of sugar oscillated between 30 and 35 per thousand, between 40 and 70 gr. per 24 hours. On February 4, the first absolute fast of 24 hours was ordered, during which the sugar disappeared entirely: but it reappeared at a dose of 30 gr. per liter, as soon as the patient ate, even meat only. So they reduced her ration, and gave her a soft drink made with bicarbonate of soda of lactic acid, and 1/2 gr. Of potassium carbonate, in water: after this treatment with a reduction of half in the quantity of meat), the sugar fell on February 12 and 13 to the proportion from 1 to 2 gr. per liter. Some thoughtlessness committed from time to time brought it back to 20 per 1000. As the ration increased, the sugar returned to 30 gr. per liter, but a new fast on February 23 made it disappear again completely: the return to the ordinary ration of meat again made traces of sugar reappear, which increased day by day up to 5, 10 and 15 gr .; note that the highest figure was reached only when the patient smoked in secret; when he did not smoke, the sugar decreased, and stood between 4 and 5 gr. per 1000. These small quantities disappeared definitively on March 19, after the administration of pure potassium carbonate dissolved in water, for four days, at a dose of 4 gr. in 24 hours. Since then, the sugar remained absent, the quantity of urine was normal, and their specific weight oscillated between 1026 and 1014. Note that this patient, on entering the Clinic, weighed naked (with his shirt and underpants, and he was is always weighed with the same clothes): 

January 19, 1874 ....... kil. 49,500 he first continued to lose weight and weighed, - January 21. the 24th the 29th February 2 ... the 4 kil. 48,900 48,600 48,300 48,000 47,500 ”after which it began to resume on February 7th. the 11 the 12 the 13 kil. 48,200 48,600 48,800 49,200 to decrease and descend on February 15 to ........ kil. 48,500 and return on February 20 to ..... . kil. 48,700 and go back down following diarrhea on February 22 to .... kil. 47,200 The weight rose quickly, so much so that it reached on February 23 ... 27 kilos. 47,800 48,800 and remained such for some time, with insignificant oscillations, after a purgation, it descended on March 8 to ...... kil. 47,500 oscillations which are largely understood by the fact that the intestine is more or less full. After the complete disappearance of sugar, the weight of the body gradually increased: we found >>> >> >> on March 19th. April 24 28 April 11. the 13th the 17th the 19th the 27th May 1st. the 5 the 6 the 22 kil. 48,200 48,700 49,300 49,600 49,800 50,100 50,700 51,000 51,700 51,900 52,700 53,100 >>) »» So that since February 22, the day of minimum weight, he had gained in three months of treatment, 5 kil. 900 gr. The temperature always oscillated between 36 and 37 ° C., the pulsations which initially were between 50 and 60, were maintained later between 64 and 72, sometimes going up to 80: the breaths were always between 20 and 24 Minute. 

On May 20, this patient, who as a student had, since April, obtained permission to go out every day, suddenly presented sugar in the urine, 8 gr. per liter and per day. Although the patient affirmed that he had not eaten outside of the clinic, I learned that for several days he had been taking rum, which in Naples always contains a lot of sugar: we are willing to believe that he hadn't eaten anything else. In addition, he was struck with a stone in the chest in the street, and so violent that he was thrown to the ground unconscious, felt pains in the right subclavicular region, a region which had been directly struck: he also had a little fever with sonorous groans with small bubbles. 

On May 21, the sugar had reached 10 gr. per liter, from the 22nd it dropped to 4g., on the 23rd and 24th it was maintained at 3g. to disappear on the 25th and remain absent until the 30th, the day when the patient escaped our supervision For more than 15 days this patient, according to his own confession, made when I presented him to my audience to take leave, was eating fresh beans (!), cherries, other fruits, and drank wine. Despite this the glycosuria had ceased. She had not yet reappeared at the end of July, the patient assured me in a letter, although for 12 days he had eaten not only green vegetables, but also milk, cheese and fruits (among which the sweeter ones, like pears, plums, etc.) and half-flour, beans , fresh peas, and eat them up to two kilograms per day (!). The circumscribed pneumonia had somewhat reduced the patient's weight: from 53kil, 1, maximum weight on May 22, it had gradually dropped to 51kil, 4, on May 28, to rise to 53kil, 2, on June 23. 

In a patient as advanced as this one, I would not have allowed the return to the mixed diet, or even to the Bouchardat menu, before at least six months of rigorous treatment, after the disappearance of the sugar. - If I report this observation among the cases of cure and the last, I must make this reservation that I am in doubt about it: the cure is not final: it is too short a time since he returned to the use of milk and fruit, etc., and then he abuses them again. In any case, this patient has demonstrated that even very advanced diabetes can be cured when the cure is carried out with all its rigor (1). (1) As I correct the proofs, I receive a final note about this patient. In the second half of August, after further abuse of fruit and wine, this patient again noticed sugar in his urine, and by an approximate calculation evaluated it at 5 or 10 grams per liter. He suspended the use of fruit for a single day, and the sugar disappeared. 

At the beginning of October, I received a letter from the father who told me: "For a month the sugar had reappeared following a new abuse of fruit and even bread: we knew afterwards that he had also abused liquors and pills containing vomit nut: he took eight in a single day, whereas he should only take two or three. This gave him a sharp intestinal inflammation, from which he died on September 28 ”. So he died of intestinal inflammation! (Author's note.)

Diabetes mellitus and its dietetic treatment

Incredibly, many of Dr Cantani's diabetic patients were doctors themselves - and they too found that the all meat diet, when done rigorously, worked to cure diabetes. "This case also teaches that there is no need for trauma or moral suffering to reproduce diabetes: the abuse of hydrocarbons is enough." Observations 51-60.

OBSERVATION LI. MRG, 47 years old, from Terra di Lavoro, a habitual amylivore, with an adipose constitution, himself noticed polyuria in 1871, and a few months later progress in weight loss and weakness: for that, and for unquenchable thirst, with continual dryness and ar- teness of the mouth, and above all for sexual debilitation, he had recourse to his doctor, the distinguished doctor Leonardo Bian- (1) In Barth, Gazzetta di medicina e di scienze naturali, di Malta, di GAVINO Gulía, Anno II, Nov, 15 and 16. Malta 22 luglio 1873. (2) In Barth, loc. cit. and all the diabetic symptoms were gone; since then he has been doing well. This observation has already been published by Dr. P. Sammut (2). chi. In April 1873 the urine, about 7 liters per day, had the specific weight of 1035, with 130 gr. of sugar per liter, about 900 gr. per day. After a cure almost exclusively meat, with tolerance of a few berberages, a little butter, a little red wine, which was prescribed to him by Doctor Bianchi, the patient improved extraordinarily quickly, so that ' after eight days, he emitted only 2 liters of urine, with 70 g. of sugar per liter, 140 gr. about sugar per day; after five more days, he emitted only a liter and a half of urine, with 49 g. of sugar per liter. Consulted on May 4, I insisted that the cure became rigorous, I prohibited butter, vegetables and wine, granted by the transaction of Doctor Bianchi: after fifteen days, the sugar completely disappeared from the urine, the volume of which fell to 700 cc, the patient regained his strength and has been doing well until this day (September 1874), where I have received news from him: for more than a year, he returned to mixed feeding. 

OBSERVATION LII. - M. Guiseppe Durini, 47 years old, from Bolognana (Chieti) (1) very fat in 1866, usually eating large quantities of flour, fruits and sweets, began little by little, without any known cause, and especially without having experienced any moral emotion, to lose weight; in the last seven months he became extraordinarily emaciated: at first, this symptom was attributed to diarrhea which had occurred in the meantime. Finally he showed himself to Doctor Colombo de Nicola, who noticed polyphagia, polyuria, polydipsia, vision impairment and impotence, suspected diabetes and confirmed this suspicion by urine analysis. On January 2, 1874, the patient emitted 5 liters of urine in twenty-four hours, with 65 gr. of sugar per liter, which makes 325 gr. of sugar per day; after eight days of rigorous treatment, Primavera observed the complete disappearance of sugar. The patient continued to be perfectly well; he returned to see me on April 7, 1874, comforted, flourishing in appearance, perfectly healthy, ruddy in color, with greatly improved eyesight. I allowed her the pastures, the wine, the coffee (without sugar), some unsweetened fruits. I saw him again in the best state of health on May 17, 1874: his urine was completely free of sugar, weighed 1022, because it was rich in urea by the fact of (1) He himself wanted to be named here, meat diet; I then allowed him the starchy foods: at the last I heard he was still doing very well, and feeling stronger than ever. 

OBSERVATION LIII. - Doctor G., a very distinguished doctor and director of a hospital in one of the most important towns of Campania, about 50 years old, of fat constitution, lover of starches, contracted diabetes mellitus in 1871, presenting the usual symptoms, with weight loss and considerable weakness. Having learned of the happy results that I had since obtained at my Clinic, which a young student of his parents attended, he submitted to my treatment, and followed it with great rigor. He recovered completely, and used a mixed diet for a long time: today he has gained weight again, he is flourishing in health, and a few weeks ago (August 1874), I saw him in consultation for one of his patients (1). 

OBSERVATION LIV. Doctor Pasquale M., distinguished doctor from Salerno, about 60 years old, of normal constitution, extremely amylivorous, suffering from diabetes for two years, with all the ordinary symptoms; so emaciated and weakened that it was difficult for him to continue his visits, and a little frightened also by the sight of the progress of the diabetes in the dean and the most renowned of the doctors of Salerno, Doctor Centola (who never did the treatment of rigorous meat diet, wasting his time taking arsenic, strychnine, and following the Bouchardat diet), Doctor PM submitted to my treatment, followed it rigorously, and recovered completely; therefore, fully recovered in possession of his strength and with normal urine, although he had returned to mixed food for about a year, I saw him again a few months ago (in March 1874 ), in a consultation in Salerno, which he attended as an attending physician. 

OBSERVATION LV. - Dr. Guiseppe B., from Randazzo, who usually ate a lot of starchy foods, ill, according to what he wrote to me, for three and a half years, is now fully recovered: his urine are normal in specific weight, free from sugar, although, for several months, (1) Special considerations, and the wishes of this distinguished colleague himself, require me to suppress the other details: it is the same for the following cases. he returned to a mixed diet about a year ago. I saw him again a few months ago (in March 1874), in a consultation in Salerno, which he attended as an attending physician, he returned to mixed feeding. On February 26, 1874, this distinguished colleague wrote to me that having interrupted the rigorous treatment too early, he relapsed four times, so much so that he began to regard my treatment as a palliative which suppressed, but did not cure diabetes; but after having followed it for a sufficient time, he was able to return to a mixed diet without seeing the sugar reappear in the urine: he then reconsidered his previous opinion. 

OBSERVATION LVI. MF Saverio M., from Borgia (Cantanzaro), 53 years old. At the age of 40 he experienced, as a result of serious sorrows, sufferings in his stomach and intestines, with diarrhea: but he recovered completely, got married at 14, had children and did well until the age of 49. At this age, and with no known cause (apart from the daily abuse of mealy seeds), he began to present the first symptoms of diabetes, which he recognized in him a year later by Doctor Cirillo, who prescribed him a treatment which was followed for two and a half months , and which consisted of a diet composed mainly of meat, eggs and milk, with limitation for the use of flour, all accompanied by a prescription of cinchona, strychnine, rhubarb and baking soda. A great improvement followed, but hardly the cure ceased, the patient relapsed and more seriously than the first time. So Doctor Cirillo prescribed a more rigorous treatment, ours, forbidding the use of fruits, milk, vegetables and flour, and adding lactic acid to the previous drugs. The patient got better again, but as he was not sufficiently rigorous in his diet, he presented on January 27, 1874, when I was consulted, 30 gr. of sugar per liter, with a polyuria of 2 to 3 liters per day, and the specific weight of 1023. Subject to my rigorous treatment, the urine, examined on February 15 by Professor Primavera, had the specific weight of 1015 and was completely free of sugar; they were still similar on April 27, 1874. The patient continues to be well, although he has resumed the moderate use of flour. 

OBSERVATION LVII. - Mr. Giacamo F., 33 years old, from Tunis (Africa), client of Doctor Quintilio Mugnaini. He had two brothers who died of diabetes, the second from phthisis after consulting the best doctors in the largest cities in Italy, the rigor of my cure. The patient himself, as his brothers had done, ate almost exclusively on flour and very fond of sweets; he never had moral emotions. In September 1873, he noticed that he had a slight polyuria, that he got up three times at night to urinate, while before that he always slept through the night. The example of his brothers made him seek advice from his doctor, Doctor Quintilio Mugnaini, who analyzed the urine with the help of the pharmacist Sinigaglia, and finding them sweet, diagnosed diabetes, and submitted the patient to my cure. After three days, the urine was free of sugar; after ten days, he ate a little bread, and the urine picked up a little sugar, but with a much less clear reaction than the first time: this sugar disappeared again after a more careful treatment of two months. After forty-five days the patient returned to a varied diet, for he was feeling quite well, and his nutrition was good. On February 25, 1874, he came to Naples, and wanted to consult me: his urine, examined by Professor Primavera, was free of sugar. This case is very interesting because it demonstrates, not only that diabetes is often a family disease, thus affirming its constitutional character, but also, by the sad antecedents of the two brothers, neither long enough nor rigorously enough. treated, that the third brother followed the same route and succumbed, if he had not been saved by coming in time to be treated and to follow the treatment exactly. He also demonstrates that there are not two kinds of diabetes, one curable, the other incurable: curability depends on the degree reached by the disease, on the period at which the disease is recognized, and the patient subjected to rigorous treatment. 

OBSERVATION LVIII. Mr. Carlo de S., 44 years old, military employee on the island of San Stefano. As a result of a great abuse of starchy substances, for he seldom ate meat, and without any other known cause, he suffered from diabetes; for some time he kept his illness concealed, although he suffered from polyuria, with thirst, impotence, great emaciation and extreme weakness. In June 1873, the presence of sugar was found in the urine, and he followed a treatment, but not with sufficient rigor: he ate almost exclusively meat, bis. The sugar gradually disappeared from the urine, and the treatment continued for five months. The urine remained free of sugar, and the patient recovered, assumed a flourishing appearance, and felt robust and strong. Having returned then to abuse flour and to abandon the meat almost completely, after a month we found sugar in the urine, but in small quantities. Professor Primavera, on March 1, 1874, found only 5 gr. of sugar per liter in urine emitted on an empty stomach at 11 am; the urine presented this interesting thing, that it was rare in the morning, but very abundant after the meal, during which he consumed so much flour. The urine, after the meal, contained up to 50 gr. of sugar per thousand. It is a kind of intermittent diabetes depend on the diet, such as starting diabetes. On March 23 began my rigorous cure, and shortly after the urine was completely free of sugar. In June 1874 he was still doing perfectly well, although he returned to a mixed diet after only a month of rigorous treatment. 

OBSERVATION LIX. Mr. Nicolangelo S., 53 years old, from Forino (Avellino). Diabetic since August 1873, by abuse of flour and without other known cause, he also presented a symptom of beginning diabetes, that of the intermittence of diabetic phenomena (polyuria, thirst and sugar in the urine, only after meals, usually rich in starch; in the morning urine is normal and completely free of sugar). - Come to Naples to consult me, he presented me, on January 3, 1874, urine emitted after meals, and whose specific weight was 1034, with 60 gr. of sugar per liter: he immediately submitted to my rigorous cure; from January 22 the urine was sugar free, and weighed 1018: the same on February 23. The severe cure was only continued for a short time: nevertheless, according to the news received, he is still doing perfectly today, although he makes moderate use of the mixed diet. 

OBSERVATION LX. Mr. Aniello S., lawyer, 47 years old, from Carbonara de Nola. Recognized diabetic by Doctor Mele in Ayril 1872; after 2 days of rigorous treatment, his urine no longer contained sugar; he continued thus for a month only, and then was very well, although he ate everything; however relying too much on his regained health, then he abused for a long time flour, sweets and wine, so that again contained sugar; however, the patient was subjectively well. He resumed the cure in January 1873, for 40 days; his urine got rid of the sugar, and he was well, although he ate everything. But in the carnival of 1874, returning to the abuse of sweets, he began to urinate more, and felt his virile power go away: the urine examined contained sugar: here is therefore a relapse after 13 months of well- be and mixed diet, brought about by the abuse of sugary foods. On March 7, 1874, the urine examined by Professor Primavera showed the weight of 1035 with 70 gr. of sugar per liter: but there was no polyuria yet. The cure resumed, the sugar soon disappeared, and the patient regained virile power. - He continues to do well, to what Dr Mele assured me in September 1874. - What is remarkable in this case is that it shows that an individual, who has once contracted diabetes, should not never again abuse the sweets, which are even more perilous and harmful than the mealy ones themselves. This case also teaches that there is no need for trauma or moral suffering to reproduce diabetes: the abuse of hydrocarbons is enough.

Le diabète sucré et son traitement diététique. (Diabetes Mellitus and its dietetic treatment)

Italian physician Cantani locks diabetic patients into rooms and uses fasting and a carnivore diet of lean meat, fat, and dilute alcohol to treat diabetes and his obituary spoke highly of him, saying he had a "clinical eye". He wrote a 500 page textbook on diabetes with recommendations to eat an exclusive meat diet to prevent glycosuria.

Nineteenth century diets for diabetes were just as varied as those of the twentieth century. The Italian physician Cantani, who had a large and lucrative private practice, enforced starvation by locking his patients in their rooms and feeding them on lean meat, fat and dilute alcohol [5].

Cantani treated his diabetic patients by eliminating carbohydrates and prescribing an exclusive meat diet.[3] He believed that stopping glycosuria was the major method of controlling diabetes.[4] He allowed his patients as many calories as they could tolerate without glycosuria. Later he limited daily food intake to about one pound of cooked meat. If glucosuria persisted, he fasted his patients.[5] The exclusive meat diet would continue for several months but if urine was not free of sugar it would extend to six or nine months.[3] To control glycosuria, Cantani would enforce his diet restrictions. He would often lock his patients in a room, so they adhered to the strict diet.[6] He performed microscopic studies on the organs from thousands of cases and observed that atrophy and fatty changes were more frequently found in the pancreas of diabetic patients than of non-diabetics.[7][8]

Professor Arnoldo Cantani, one of the most brilliant and distinguished of Italian physicians, died on May 1st, aged fifty-seven. His death was caused by Bright's disease, a malady concerning which he had written much. He was at the time of his death Professor of Clinical Medicine in the University of Naples. While at Naples he wrote monographs upon the “ Diseases of Metabolism,” “ Progressive Atrophy of the Skin," “ Lathyrismus," “ Enteroklysma,” “ Different Morbid Aspects of Individual Infective Disease,” to say nothing of a vast number of occasional monographs and notes on his favorite themes of fever, inflammation, and infection. “ The predominant note in Cantani’s character," writes a Neapolitan correspondent of The Lancet, “ was serenity. No one possessed a calmer, more perfectly balanced judgment; no one was further removed from all that savors of flattery or assentation. He had in a rare degree what professional men call the ‘ clinical eye ’ —a possession all the more remarkable in that he did not lay himself out so much for consultant practice as for investigation in the pathological laboratory. The honors, of which he had more than his share, came to him unsought, and he never was heard or seen to set store by them. Called in 1889 to the Senate of the kingdom, his health, never robust, kept him from taking part in its deliberations, except in rare crises in the State. Outside his professional sphere, and that was an extensive one, he had but one predilection—he was passionately fond of music.”

ARNALDO CANTANI, M.D., Professor of Clinical Medicine in the University of Naples. WE regret to announce the death of Professor Arnaldo Cantani, one of the foremost physicians and teachers of Italy, which took place on April 29th. He had been disabled by illness for about two years, but the end came somewhat unexpectedly on the twenty-fifth anniversary of his induction into the chair in which he won distinction as one of the most influential reformers of medical teaching in Italy. Cantani was born at Hainsbach in Bohemia in 1837, but his father was a Neapolitan. In 1855 he entered on the study of medicine in the University of Prague, where he took his degree in 1860. Immediately afterwards he was chosen by Professor Jaksch to be his principal assistant, and for some years he was Privat-docent, taking the professor's place in the lecture room on several occasions with much acceptance. While at Prague he translated Niemeyer's work, Special Pathology and Therapeutics, into Italian. There also he became acquainted with bsalvatore Tommasi, who was destined to take an equally prominent part in the medical renascence of Italy In 1864 the Italian Government offered Cantani the Chair of Materia Medica and Toxicology in the University of Pavia. In 1867 he won by competition the appointment of Physician and head of the Medical Clinic at the Ospedale Maggiorept Milan. Finally, in 1868, the Italian Government invited him to fill the Chair of Clinical Medicine in the University of Naples, which he continued to occupy till his death. So attached was he to the country which had readopted him, that he declined an offer of one of the chairs of clinical medicine in the University of Vienna, which was made to him on the death of Bamberger. 

Cantani's influence as a teacher made itself felt chiefly In the infusion of the modern scientific spirit into Italian medicine, which even thirty years ago was still largely under the sway of " systems," in which facts were' made to fit the Procrustean bed of theory. Cantani laboured by precept and example to rehabilitate the accurate observation and careful collection of facts which had in the sixteenth and seventeenth centuries been the distinctive features of the Italian schools. 

Cantani contributed largely to medical literature on cholera, typhoid fever, rabies, and diabetes. His most important work was his Trattato di Aateria Medica e Farmacologia; his last publication was a work entitled Pro Sylvis, which was a plea for the preservation of forests from the hygienic not less than the aesthetic point of view. 

His funeral was attended by the whole medical faculty of Naples, by representatives of the Senate and Chamber of Deputies, by the Minister of Education, and by the administrative and executive authorities of the province of Naples, and an immense concourse of the general public. Funeral orations were delivered by Professor de Amicis, President of the Medical Faculty, by Professors Gallozzi, De Renzi, and others.;page=ssd;view=plaintext;seq=28;num=14

"According to Vierordt, humans must necessarily absorb 120 grams per day. of albumin, 90 gram. of fat, 330 gram. of hydrated carbides, 2.635 gram. of water and 32 gram. mineral salts. These numbers would be an average. We can take them as such, and take them as a starting point in our studies or our experiences. Let us now study the toll of carnivores, and notice that meat does not is not only albumin, that it contains a quantity of combustible substances: gelatin, fats, muscle sugar, lactic acid. To feed a dog exclusively with meat, it is necessary to give him 40 to 50 grams each day. per kilogram. of its weight: below it will lose weight, above it it will increase in weight. Sees has found that under these conditions a dog absorbs more oxygen than with a mixed diet, and from the therapeutic point of view this is very important: this increase is due to albumin, not to fats nor with gelatins. Digested and assimilated albumin is not used in a single form: according to the uses to which it is to be employed, it will be transformed in various ways; it will take two main forms, which Voit has thus designated: tissue albumin (Organeiweiss), and circulating albumin or provisional albumin (Circulirendes Eiweiss, Vorrathseiweiss), or else blastema or plasma. On this point, Sees is agreement with Bischoff, J. Ranke and Weigelin, and also with our own research. "Tissue albumin" which we prefer to call organized albumin, constitutes the solid parts of tissues, membranes and cell nuclei, it is not as easily attacked by oxygen as "circulating albumin" which I call fluid albumin and which constitutes the amorphous liquid content of tissues. The more meat is eaten, and the more it accumulates in the body of circulating fluid albumin, the more oxygen it absorbs to burn this excess albumin, and produce urea or acid. uric. When a dog is fed on meat and fat, this last substance is an excellent fuel, which spares a lot of albuminates, by burning itself in their place, and taking their oxygen from them, which makes them less combustible. From this results this fact, that such a diet increases the weight of the body, the mass of the flesh, and sometimes also the fatty deposits. In the balance sheet of omnivores, it is about saving as much albuminates, supplying the organic oxidation process with another fuel that is even more economical than fats. By giving the dog meat and hydrocarbons, one could theoretically expect a greater saving of albuminates, since hydrocarbons are more combustible and more oxygenated than fats. In fact, this is what takes place: albuminates are spared, as well as fats, the accumulation of which is thus favored; if the hydrocarbons are introduced in excess, they very markedly decrease, according to Voit, the organic consumption. According to Pettenkofer and Voit, two parts of hydrocarbons are equivalent for the carnivore to one part of fat. Bread alone would not be enough to feed carnivores, or even man; to introduce a normal quantity of nitrogen, it would be necessary to absorb too much starch, which would not be tolerated for long. According to Ranke, collagens do not only spare albuminates, but also fats and even hydrocarbons circulating in the plasma stream: however this excellent fuel would provide little heat. The inorganic substances contained in our food are also of very great importance for nutrition and material exchange; the main ones are: sodium chloride, salts of soda, potash, lime, magnesia, phosphoric acid, water. All these inorganic bodies accelerate the endo- and exosmotic current, the plasma current, and increase the oxidation of circulating albumin. The salts of potash, and especially the phosphate of potash, promote, according to Kemmerich, the production of muscular tissue; according to Ranke, these potassium salts decrease the resistance to cells, would allow an easier passage of the plasma current, and would also promote the organization of albumin or albumin formation of tissue. The excess po- cup would become harmful by the too great depression of the vegetative activity. Water is essential as a liquid menstrual for all processes of diffusion or transformation, oxidation or decomposition, introduction or export. But the excess water in the tissues indicates a sluggish life, a slow and lazy renewal. The balance of herbivores is not essentially different from that of carnivores. The materials used are different, but the results are much the same. Herbivores introduce much more fuel, which promotes fatty deposits; it also seems that they digest at least part of the cellulose, which no carnivore does, including humans. By giving the herbivore nitrogenous food, we do not increase its musculature, but only its reserve of fat. Man is omnivorous, he eats everything: he offers considerable resistance, lives longer than most animals, thanks to his varied and restorative diet, but above all thanks to the influence of his system. nervous system so developed, on vegetative activity and the renewal of its tissues. Meat is certainly his primary food, for hunting, fishing and herding herds preceded agriculture; bread came in later. But the flesh, which man digests very well, remains his best food; it makes him stronger, more energetic, more resistant than is the man living exclusively on vegetables and fruits. And it is with peoples as with individuals: herbivorous peoples degenerate, carnivores progress, in this meaning we could say that the cuisine of peoples is part of their national history. The material renewal varies in intensity according to the various ages. The child oxidizes more, but produces more than he consumes: it is the most plastic age. Likewise, but to a lesser degree in the young man. In middle age, balance is established. In the elderly, despite less consumption, production was no longer sufficient to cover the deficit; regressive metamorphosis wins; it is the organism's first step towards returning to the inorganic state. Let us also note organic individuality as the cause of a variable renewal, too rapid in some, too slow in others. Assuming the correct proportions of the foods introduced, we can distinguish four ways of being of material renewal: 1 ° Regular and balanced renewal; 2 ° excessive consumption; 3 ° self-consumption or autophagy; 4 ° lack of water. In the first case, physiologists admit that all the albuminates introduced replace an equal quantity of organic substances; the more we introduce, the more tissues to renew will be consumed; all the decomposition products found in the urine and other excretions would therefore come from the tissues burned and consumed, and not from the albuminates introduced by the diet. In excessive consumption, there would be an excess introduction of albuminates, only a part of which would serve to renew the tissues, while the other would be burned directly in the blood. The body would not gain weight, since the amount of albuminates intended to increase body mass would be used as fuel. For me, I believe that even in humans well;

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The fats introduced into the organism are burnt there, and give as the last residues water and carbonic acid. The hydrated carbides are starch and scre, and since starch always turns into sugar, all hydrocarbons should be considered sugar. By oxidation they are transformed into lactic acid, and give as last residues water and carbonic acid, as do fats

Page 33

To this order of abnormalities belong according to us: diabetes mellitus, oxaluria, gout, uric and calcareous gravel, adipose polysarchaia. (6) Renewal anomalies with consecutive systemopathy by abnormal elaboration of nutrient materials absorbed into the blood, among which we note: Rickets, Osteomalacia, (c) Renewal anomalies with consecutive systemopathy, for example excess or insufficiency in the absorption of certain food substances, which would be scurvy, hydremia and hydrorgania. 2 ° Renewal abnormalities with systemopathy by constitutional defect, which primarily resides in the tissues themselves, irregularly developed, and, for that, endowed with abnormal reactions or little resistance: the main ones are: Nervous erethism, Scrofulosis, Hemophilia, Chlorosis. 3 ° Anomalies of material renewal with systemopathy, having the character of reaction to agents hostile to organic life, which have penetrated into the tissues or into the circulating blood: these harmful agents come either from the economy itself , or from the outside world, and disturb the renewal of the chemical and morphological cular. Here we find: Fever, Primary phlogosis in general, and in particular acute or chronic rheumatism, certain generalized eczemas, certain fleeting erythemas, urticaria, etc., Virulent infection (contagious diseases and mias - matics), Chemical poisoning (acetonemia, cholemia, ammoniaemia, blood dissolution), Chemical poisoning (lead poisoning, arsenicism, hydrargyrosis, etc., ergotism, lathyria, etc.). In diseases where the whole organism changes its type of vegetation, of chemical direction, the organism transforms food substances to a certain point, without leading them to complete decomposition, thus interrupting the series of normal transformations. Its processes of biological chemistry are no longer sufficient for their task, and the imperfect products of their elaboration remain useless or harmful: these products, by accumulating, all become in the long run very harmful. Examples include diabetes, gout, polysarchaia, oxaluria. The diseases of this group can affect the entire economy more or less seriously, preferably without affecting any organ. Other times the abnormal or retained products almost exclusively affect certain organs or certain tissues, which should have eliminated them in another form, as happens with kidney stones, including oxaluria. At other times the whole organism is affected, but certain organs feel it especially and in a very special way,

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By systemopathies I mean those diseases of renewal, those anomalies of organic chemism, in which the disturbance of the processes of chemical transformation affects the nutrition of the whole organism less than that of a specific type. of tissue, of a physiological and histological system of our tissues. Given an alteration of the blood crase, it is easily understood that certain tissues suffer from it more than others, and that this influence extends to all the tissues having between them a certain affinity of nutritional needs, and belonging to the same histological system. A chemical substance whose presence or preponderance in the blood will alter the nutrition of a bone, can and must interfere with the nutrition of other bones: from then on all other bones will be disposed to become diseased, if an occasional cause occurs. Likewise, a substance capable of making the serous membranes of the joints sick can act on the pericardium, endocardium, pleura and other serous membranes. This is the case in rickets, osteomalacia, scurvy, hydremia, hemophilia, scrofulosis, nervous erythema. Finally, in the diseases which have a character of reaction to the harmful agents which have penetrated into the blood, we find above all affected a physiological system: the skin and the mucous membranes in eruptive fevers, the hemocytopoetic and lymphatic glandules in the ileo - typhus, muscles and nerves in lead poisoning, muscles in lymphadenism, etc. In phlogoses which present several foci, It is understood that there is not a single disease without secondary alteration in the composition of the blood, and without at least a local disturbance of molecular renewal. This disorder can spread secondarily to the entire economy. In the course of these lessons, we will mainly deal with the diseases that have been studied in our studies from the point of view of molecular renewal. The most completely treated will be diabetes mellitus. We will speak of others, as much as is possible in the present state of our knowledge, from the pathologico-etiological and therapeutic point of view.

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The Portuguese Amato Lusitano says he cured two diabetics by a very nourishing diet and the use of purgatives. Maybe' Were there cases beginning treated by the diet especially meat. Another Portuguese, Zacuto Lusitano, cures two cases with donkey milk: this is very interesting if we think of the undoubted advantages that we have obtained from the use. lactic acid, and the cure by the milk diet proposed today in England by Donkin. The Italian Cardano had the opportunity to study diabetes on himself, probably it was diabetes insipidus. He also describes a case observed in a young girl, and the first he weighed the urine: according to her calculation, this young girl absorbed only 7 pounds of solid food or drink each day, and gave 36 pounds of urine.

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Sydenham came up with an idea, which is like the prelude to current ideas. According to him diabetes is an assimilation disease, in the sense that the chyle is not fully digested in the blood, and should therefore be eliminated by the kidneys as a foreign body. For treatment he strongly recommended a rich diet in meat, and narcotics, especially theriac.

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Morton regarded diabetes as a kind of phthisis, and attributed the mild flavor of the urine to the flow of the sweet chyle to the kidneys. In etiology, he cites the influence of heredity, kinship, race. He encountered diabetes in the father and son, and another time in a small child who had lost three brothers to diabetes. 

Mead maintains that diabetes is a disease of the liver: he wants to prove it by autopsies which all showed him steatomatosis of the liver. He explains the sweet taste of urine by the separation of salt from bile. 

Dobson demonstrated that diabetic urine can produce alcohol and vinegar by fermentation: he succeeded in preparing very clearly sugar by evaporating the urine: he also discovered the sweet flavor of the serum of the blood of diabetics, and thus demonstrated that sugar exists in the blood of these patients and is not formed in the kidneys.  According to him, it is a defect of assimilation of the chyle which causes the glycosuria: the sugar of the chyle accumulating unaltered in the blood, would come out by the urine. This shows that Dobson already admitted the passage of sugar from food into the blood; he also admitted an abnormal fermentation, and believed that the acidic breath of diabetics was due to the acid fermentation of the sugar contained in saliva. 

Cullen said the diabetes was neuropathy, a spastic disease. However, he recognized the vice of assimilation of chyle. He denounced the ineffectiveness of all remedies. 

Home recognized that by weighing not only the drinks introduced, but also the more or less liquid foods, the quantity of urine does not exceed the quantity of liquids absorbed; he also noticed that the quantity of urine emitted is greater at certain times. Home made quantitative analyzes, and weighed the sugar obtained; he had in one patient an ounce of sugar for a pound of urine, in another an ounce and a half. He confirmed the fermentation capacity of urine with the addition of yeast, and thus showed that it lost its sweet flavor to take on that of small beer. As for the theory, he accepted Dobson's: he treated his patients with a diet consisting mainly of meat.

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Here we close our second period by noting that several of the authors cited lived after the publication of Rollo's works, works intended to prepare for the era of experimental studies. The third period, therapeutic period, is again inaugurated by an Englishman, John Rollo, who at the end of the last century published the story of two cases of diabetes. Rollo was the first to emit, on the pathogenesis of diabetes, a theory which, modified on various points, became widely later; many authors attribute their authorship to Bouchardat. According to this theory, diabetes is a disease of the stomach with overactivity, with exaggerated secretion of abnormal gastric juice, which converts all starchy substances into sugar; this sugar absorbed in the blood would come out with the urine. Note, however, that Rollo did not know that starch normally turns into sugar. This is why he advises to treat diabetes with an especially animal diet, and with drugs that slow down the activity of the stomach: vines and fats only at dinner and at supper: at breakfast one and a half liters of milk, with buttered bread. As drugs, ammonium sulphide, opium and emetics. This treatment, as we can see, somewhat resembled the Bouchardat or Seegen regime. In the hands of Rollo and his contemporaries, he gave mediocre results, which the author attributes to the inaccuracy of patients in following their diet: he notes that they have frequent indigestion, disgust for meat, gastroenteric catarrhs, and he attributes all this to the meat diet: it seems to us that one could, with all appearance, attribute to the drugs indicated above ammonium sulphide, ipecac, stibiae tartar, etc. My patients tolerate a much more rigorous diet and that for several months; they digest very well and eat perfectly. 

After Rollo we have Bouchardat who adopted the same theories, however modifying them so as to adapt them: 1 ° to the discovery made by Tiedemann and Gmelin, that starch is normally transformed into sugar in the intestine, by action of saliva, pancreatic and enteric juice, 2 ° to this fact, demonstrated by Magendie, that this sugar is normally absorbed in the blood. Bouchardat, also admitting that the cause of diabetes is stomach disease, says that starch is transformed into sugar so quickly that too much of it enters the blood in a given time, and the blood, overloaded with sugar, lets part of it escape through the urine. This is Rollo's theory and the same overactivity of the stomach: it is still the same therapy. Bouchardat menus have become famous: meat, cabbages, peaches, lemons, gluten bread, which should only contain nitrogenous substances, and which, in fact, contains far too much starch. It cannot be denied that, of all the treatments offered so far, that of Bouchardat, which basically is that of Rollo, minus ammonium sulphide and emetics, has had the best fortune and deserved it. The goal was not completely achieved, because the regime is not severe enough, but it is very close to the truth: none of the authors and practitioners who came after Bouchardat could neglect the use of his culinary menu. 

Prout also believed that diabetes is a form of dyspepsia: but he saw it as a defect in stomach activity, a difficulty in assimilating sugary foods. 

Gregor, from London, argued that diabetes resides in the stomach. 

Griesinger expressed the opinion that diabetes depends on rather qualitative disturbances in the digestive functions of the stomach, because the disease often begins with noticeable disturbances in digestion. According to him, the great thirst of the diabetic who eats starches, his less thirst when he eats meat, cannot be explained, with the hepatic theories of diabetes, but rather by gastric digestion disorders, by the rapid transformation of starch into sugar, and rapid absorption of sugar into the blood. In addition, the alteration of the digestive ferment of the stomach is a proven fact; the stomach juice of a diabetic on an empty stomach, obtained by vomiting, would contain a ferment which rapidly transforms starch into sugar, which normal gastric sugar would not. Griesinger regrets that this difference has not been sufficiently taken into account; he also admits as possible that, in the stomach and intestines, the albuminates ingested provide sugar in diabetics.

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