Doctor Aldridge was advised to give up all visits, and pass the winter entirely within his house, to abstain from vegetables, sweet and home made wines, to which he had been, particularly partial, and all redundance of sugar, of which he was fond, and to pursue the plan of medicine stated in his letter to you. I do not think, at his age, the cure could have been more complete.
October 18, 1797
Cases of the diabetes mellitus: with the results of the trials of certain acids
From Doctor Storer, Nottingham. October 18 1797
THAT the cure of the Diabetes Mellitus had hitherto been a desideratum in Medicine, the candid declaration of Dr. Cullen will leave no room to doubt; and though I have reason to think that there exists in certain families a morbid disposition, occasionally showing itself in profuse and sweet urine, thirst, eagerness of appetite, and feverishness, which is relieved by medicine, disappears of itself for a time, and recurs upon any irregularity, much as happens in dyspepsia, yet I think a distinction ought to be made between this milder and more chronic species of the disease and the true Diabetes Mellitus, with rapid emaciation, as described by yourself and others. Respecting the latter, (of which seven distinct cases have fallen under my care) I must say with Dr. Currie, that after the disease was completely formed, I have never seen it cured by the former methods of practice.
The first notice I had of the new method, was from your notes of Captain Meredith's case, transmitted to me by Dr. Aldrich, (the Gentleman of 77, see page 180,) with a request to have my sentiments respecting the propriety of his pursuing a similar plan. I have reason to think that the Doctor's disease had existed a considerable time, before it was detected in September 1796, when he first complained to me of oedematous legs, great thirst and dryness in the mouth, without any corresponding degree of fever, increasing debility and frequent irritation to urine, the quantity and properties of which had not been observed, the Doctor having strongly adopted the idea, that it was more the infirmities incident to advanced life, than any positive disease under which he laboured. Having declined to recommend anything till the state of the urinary discharge was ascertained, I soon received a note to say, that the colour, taste, smell, consistence and saccharine residuum, after evaporation, all proved the urine to be truly diabetic. In consequence of this information, the Doctor was advised to give up all visits, and pass the winter entirely within his house, to abstain from vegetables, sweet and home made wines, to which he had been, particularly partial, and all redundance of sugar, of which he was fond, and to pursue the plan of medicine stated in his letter to you. Under this treatment six months elapsed before your method was known to us, during which the Doctor was in some respects relieved; the progress of the Diabetes appeared to be arrested, but all its characteristic symptoms still remained. The sequel of the case, from the end of March till the 18th of May, (the date of the report transmitted to you) is better related by the Doctor himself, than I am able to do; to this report I have only to subjoin that on the 17th of June following,
He found himself able to pass two days here (20 miles from home) on a visit. The swelling of the ankles was no more than what is customary at his age; he appeared as well as he had been for several years; and though his urine had a flight sweetness, it was neither too abundant nor otherwife defective. This state of health continued, although he had in a great measure resumed an ordinary diet (abstinence from vegetables and saccharine matters excepted) till the 14th or 15th of July, when he was seized with a cholera, at a gentleman's house in the neighbourhood; and though the bowel affection ceased, so as to admit of his being removed home, yet on the 18th I found this truly excellent and learned man in a dying state, without any other symptoms than those of debility and dyspncea; his urine was natural. The Doctor himself has stated that he would not consent to enter upon your plan of regimen in the Uriel manner that I would have recommended it to be pursued, at least for some weeks. He entirely rejected any hepatised ammonia, or any nauseating medicine. It was as a substitute for these that I proposed the soda water of Schweppe, having come to the knowledge of a diabetic case in Lancashire; which was understood to have been much relieved by that preparation; and I entirely concur in the Doctor's own opinion, that while it was a solace to his thirst, he derived other advantages from it. In fine, the benefit he experienced from the whole of the plan, much exceeded his expectation and mine; and I do not think, at his age, the cure could have been more complete.
It is with much concern I remark, that in patients under the influence of Diabetes, there is such an invincible desire for variety in aliment, and often such an aversion to animal substances, that the new method of treatment most often fail for want of a fair trial. I have at this time a man of about 50 under my care, who has laboured under this disease for two years, and who has had all along a disgust to the taste, smell, and often fight of animal food. Six months ago, I strongly recommended to him your plan of regimen; he tried it partially, I believe, without much evident effect and soon abandoned it. Taking advantage of the rapid increase of his diforder lately, and the near prospect of dissolution, if nothing essential was done, I have again enforced it with all my powers of language. The consequence has been, a fresh trial of two days, which he declares himself unable to support, and now he appears to resign himself to his fate.