On diabetes mellitus and glycosuria / by Emil Kleen.

  • Kleen, Emil, 1847-1923.
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: On diabetes mellitus and glycosuria / by Emil Kleen. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    79/354 (page 75)
    with Strict diet, this at once tells me that he is in the severe stage. It is useless to give figures of the glycosuria without some infor- mation as to the diet. With an exclusive diet of meat and fat, glycosuria, which dis- appears entirely in the mild diabetic stage, rarely reaches above two or three per cent, in the severe stage. In severe cases the patient often passes a clear, pale, greenish- yellow urine with a specific gravity that often is nearer 1.040 than 1.030, and that sometimes may reach far above the first figure. Several observers mention 1.070; Proust and Bouchard, 1.074. Diabetic urine, however, especially in mild cases, varies enor- mously in appearance, specific gravity, and other qualities. A dia- betic in the mild stage, when he has not received carbohydrates beyond his limit of assimilation, passes urine that, besides being free from glucose, is otherwise scarcely different from that which a healthy person passes under the same dietetic conditions. We quite frequently find, even in severe cases, a urine of perfectly nor- mal, sometimes even a somewhat high, yellow color, and in mild cases not rarely a strong sediment of uric acid. Under the micro- scope the conditions often are normal, although sometimes there may be a rather large amount of the small crystals of calcium oxal- ate and sometimes also occasionally hyaline and more rarely granular casts. The nitric-acid test not uncommonly discloses the presence of albumin, and the colored zone above the acid is frequently pronounced. By reason of the abundance of animal food the urea and other derivatives of proteids are generally pres- ent in rather large quantities, and the specific gravity, therefore, is often high, even when no sugar is present. In many cases in the mild stage, however, the specific gravity is below 1.030, and not only within normal but within very common limits.* One may find urines of a specific gravity of 1.020 that contain quite a con- siderable amount (above one per cent.) of glucose. Sometimes one may even find distinctly pathologic, though small, quantities of glucose in urine of an exceptionally low specific gravity. Some * A normal middle-aged man, who eats much meat, often passes urine of a specific gravity nearer 1.030 than 1.020. One may sometimes, apart from diabetes, even find the urine of comparatively normal persons with quite a high specific gravity. Only re- cently I encountered a specific gravity of 1.034 in such a case.