Among other tests may be mentioned Fehling’s, Haines’, and Dr.George Johnson’s. These latter are described in Goodno’s Practice of Medicine as follows-
HAINES’ TEST.- This test was devised by Prof. W.S. Haines, of Chicago. Directions.- Dissolve 30 grains of pure sulphate of copper in half an ounce of distilled water; add half an ounce of pure glycerine, and, after thorough mixing, five fluid ounces of liquor potassae. Of this fluid, about one drachm should be boiled in a test-tube. Add slowly six to eight drops of the suspected urine, followed by a second gentle boiling. The presence of sugar is indicated by the appearance of a copious yellowish red or yellow precipitate.
PICRIC ACID TEST (Dr. G. Johnson’s). And to a quantity of urine in a test-tube one half the amount of a saturated solution of picric acid, and the same of liquor potassae. If sugar is present the fluid assumes a dark red colour on boiling, the depth of colour depending on the amount of sugar.
The urine should be examined more than once, because the presence may have arisen from some unusual article of diet, and be only temporary. Excessive discharges of urine may also occur in Hysteria, Diabetes Insipidus, and other disorders. The most certain information concerning diabetic urine, however, may be obtained from its specific gravity, which varies from 1.025 to 1.040 or upwards, according to the quantity of sugar it contains. Whenever the urinometer stands above 1.030, we may conclude that sugar is present. But in all cases the total amount of urine passed in the 24 hours must be measured for accurate calculation.
CAUST.- A defect in metabolism, so that sugar, which ought to be available for the maintenance of the body, enters the blood, and leaves it again unchanged, and is discharged in the urine. And here we refer not merely to sugar which is taken as such into the mouth, but to that which is formed out of the starch contained in food. The underlying causes of this defect in metabolism are various and differ in different cases. Some are removable by dietetic and medicinal treatment. Some appear essentially unaffected by either.
DIABETES INSIPIDUS.- In this affection the quantity of urine is largely increased, but it is clear and colourless, of low specific gravity (1.300 to 1.007), and is devoid of sugar and albumen. Thirst; a dry harsh skin; and mental and physical weakness are generally present.
TREATMENT.- Acidum Phosphoricum.- This medicine, with attention to dyspeptic symptoms, generally relieves, and not unfrequently cures the milder cases. The special symptoms calling for it are, frequent urging to urinate, pain in the loins, emaciation, and prostration; it is particularly valuable in cases of a nervous origin. Immediate improvement ensues, both in general health and in the condition of the urine. In one case reported, at the end of the fourth week the sp. gr. was 1.018, and there was less sugar by about one-fourth. After the lapse of four months the patient was perfectly well. We have found that great benefit follows from the administration of this remedy in the 1x dilution, several times a day.
Uranium Nit.- This medicine had sometimes proved efficacious. Dr. Edward Blake’s monograph on the drug in the Hahnemann Materia Medica should be consulted in reference to it. Dr. Cornell has furnished us with interesting details of several bad cases cured by it. Dr. Holland has also reported to us a case in which, under Uran.-Nit., Ac.-Phosphorus, and bran biscuits instead of ordinary from four quarts to three pints, pain in sp. gr. from 1.048 to 1.925. The strength returned with great rapidity, the general healthy appearance was restored, and there was no relapse The Lancet gives details of a cure by Uran.-Nit. The dose of 1/6 of a grain given in water three times a day, and afterwards gradually raised to 1/3 of a grain. A week later the patient was much better, and by the end of the second week the bowels were regular, the appetite and quantity of urine no longer were regular, the appetite and quantity of urine no longer excessive. The usual diet was then resumed, and muscular weakness alone remained. (See also Homoeopathic World, vol. CST. (1896) p. 443, where reference is made to cases reported in the British Medicinal Journal by Dr. Samuel West; and vol. xxxii. (1897) p. 536.)
Syzygium jambolanum or Jumbul, suggested by Dr. Dudgeon. Terebinthina and Arum Triphyllum have also proved remedial. Helonin has been successfully administrated by Drs. Hale and Payne. Muriate of Quinine is found to remove sugar from the urine. Plumbum also promises to be a successful remedy; its action is specifically on the kidneys.
Arsenicum, Digitalis, Nux., Cantharis, Eup.-Pur., Chim., or Mercurius, are often required to meet special symptoms.
ACCESSORY TREATMENT.- Amylaceous food, and every substance containing sugar, or that is readily convertible into it, should be avoided. The most nutritious food should be preferred, and the greater proportion consumed in the fresh state. Fat meat, fish, oysters, eggs, milk, good soups thickened with finely powdered bran, cocoa prepared from the nibs, lettuces with oil, vinegar, etc., may be taken, if they agree, and be varied to suit the patient. The action of all articles must be watched, and anything that occasions indigestion or increased saccharine secretion avoided. As a substitute for ordinary bread, which is inadmissible, bran bread, or brancakes, or ground almond powder made into bread or biscuits, with eggs, are recommended. Diabetic bread, made of the following ingredients bears a closer resemblance to ordinary brown bread than any previously suggested, and is often found more palatable. To eight parts of gluten add two parts of bran nearly free from starch, and a small quantity of butter. It is more nutritious than any other, and prevents or corrects constipation. The excessive thirst of diabetic patients may be gratified, as fluids aid in the elimination of the sugar in the blood, and patients become greatly depressed if they are not allowed to drink as much water as they desire. Warm baths, the use of flannel, and a warm climate are valuable accessories in the cure of Diabetes. Dr. Bouchardat recommends laborious bodily exercise, especially gymnastics, observing that profuse perspiration on farinaceous food lessened sugar in the urine. The improvement consequent on a course of Carlsbad or Vichy mineral waters is sometimes very marked. Cold winds, sudden draughts, or changes are injurious.
In Diabetes the removal from the diet of carbohydrate material sometimes leads to excessive consumption of meat and nitrogenous food. This is very undesirable. Good results have been obtained by systematic fasting for long periods combined with free purgation, and every diabetic should fast altogether from solid food for at least one day a week. This is the most important of all recent additions to our power to aid Diabetes.
SKIM-MILK TREATMENT.- Several cases have been reported i n the medical journals of Diabetes in which the quantity of urine was steadily and greatly diminished, and the specific gravity correspondingly reduced by restricting the patient of six pints of skimmed milk per day. This treatment is cheap, and patients can adopt it without interfering with their usual occupations. Mr. H. May (Birmingham) gave five pints of milk a day to a diabetic patient, and in six weeks the specific gravity fell from 1.040 to 1.017; the patient at the same time became stout, and stronger than she had been for years. Mr. Donkin has also successfully prescribed it; but he insists that skin-milk loses its curative power altogether, and become valueless as a remedy in Diabetes, when administered in combination with solid animal or other nitrogenous food. By the skim-milk treatment, he says, I mean the administration of skim-milk properly prepared, in quantities measured and limited to the requirements of individual cases, given at regular intervals in definite doses, and to the exclusion of all other food for a longer or Shorter period. This system of treatment, in short, must be pursued in as strictly methodical manner, and according to rule; and if this is not done, success must not be expected. He gives seven to ten pints, according to circumstances, divided into meals taken at regular intervals. Two or three pints may be made into curd daily, by the essence of rennet. Dropsy has also been very successfully treated with milk diet in India. Hence we may presume that skim- milk has some effect on metabolism. After the skim-milk has been taken for about six weeks, almost every variety of animal food may be taken once, twice, or thrice daily, and bran biscuits, gluten bread, diabetic bread, and dry wines may be added by degree to the dietary.
68.- Purpura – Land – Scurvy.
DEFINITION.- A condition not usually attended by fever, characterized by purple spots of effused blood, which are not effaced by pressure, an are of small size, except where they run together in patches. This is the simple form (Purpura simplex). When the disease is accompanied by haemorrhage from a mucous surface, it is called haemorrhagic (Purpura haemorrhagica).
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."