and when it is not entirely burnt, is eliminated through the kidneys. However, all diabetics have not sugar in the urine. This substance, not being burnt, and being therefore retained in the tissues, occasions there the vague pains of which diabetics complain, and which are put to the account of rheumatism, although between these two affections there is an entire difference of origin, since the one is of a hydrocarbonated nature, and the other of an azotized nature. Diabetes mellitus ends in the production of marasmus and disorders in various organs. This diathesis must be combated by a saline regimen and by the arseniates of strychnine and of iron, in order to restore the blood to its normal condition :

Three granules of each, together, daily.

The daily use of Seidlitz salt must be insisted upon. Diabetes is often connected with a state of irritation of the spinal marrow and of the cerebral peduncles, as is observed in consequence of venereal excesses. In such cases, the employment of bromated camphor, with hyosciamine and cicutine, is indicated :

A granule of each, together, morning and night.

Diabetics are very subject to erratic fever, which should be combated every time it appears by arseniate and hydroferrocyanate of quinine :

A granule of each, together, every half-hour, during the whole duration of the accession.

Albuminuric Diathesis.-This diathesis is characterised by albumen in the urine, and is a great cause of debility. It is also often seen to supervene in cases of eclamptic convulsions, like those which occur during the puerperal period. The blood, deprived of its protein elements, becomes watery; hence, also, dropsy. The physician must, therefore, endeavour to restore to the blood its normal density, which may be brought about by a saline regimen, and to ward off anæmia by the arseniates (strychnine and iron) :--

Three to four granules of each, together, daily.

An analeptic or fortifying regimen must be insisted upon. Erratic fever, which is observed towards evening, will be combated by arseniate and hydroferrocyanate of quinine :—

A granule of each, together, every half-hour, until cessation of the fever. Chyluric Diathesis. This diathesis is characterised by white or milky urine, like chyle. The microscope, indeed, permits of the discovery in the urine of a certain number of white and red globules, and an innumerable quantity of molecular corpuscles agitated by the Brownian movement. A few fatglobules may be discovered. It is seen that these are the

elements of the chyle, and their presence in the urine can only be explained by an error loci; that is to say, these globules have been transported in the circulatory torrent as far as the kidneys.

Chyluria is a disease peculiar to hot countries, and consequently connected with a torpid condition of the liver. The curative means employed are simple. The patients should take, every morning, one or two teaspoonfuls of Seidlitz salt, and, before meals, three granules of quassine. The diet should be substantial and cooling.

Choluric Diathesis.-This diathesis is due to the presence in the urine of the colouring matter of the bile or biliphein. This latter must not be confounded with the peculiar colouring principle of the urine, which differs according to the state of the blood and nerves. In choluria, the urine is constantly acid, on account of the excess of the biliary acids, independently of uric acid. Choluria gives rise to general malaise and to sufferings in various organs, which might easily be ascribed to rheumatism. It is true that the treatment is very similar, since it consists in the employment of the alkalines and arseniates. Arseniate of strychnine and digitaline should especially be administered :

Three or four granules of each, together, daily.

Quassine must be given at the same time, in order to arouse the liver from its torpid condition :—

Two granules before meals.

Every morning, Seidlitz salt must be taken to refresh the blood.

Blennuric Diathesis. In this diathesis, the urine is habitually loaded with mucus, which acts as a ferment, decomposing the urine, and giving rise to the formation of carbonate of ammonia, which has the effect not only of irritating the bladder, but of precipitating the earthy phosphates, and thus favouring deposits of ammonic-magnesian phosphates (triple phosphate). This state will be counteracted by the daily use of Seidlitz salt, and by the employment of benzoate of soda.

Alkalinuric Diathesis.-Alkalinity of the urine may depend upon the presence of fixed or volatile bases. The fixed bases are soda, lime, and magnesia; the volatile base is, ammonia. The fixed bases arise generally from foods containing a large proportion of alkaline salts, or from waters charged with calcareous matters. The alkaline waters, such as those of Vichy, Vals, Contrexeville, Carlsbad, Marienbad, etc., may also produce this result. The volatile base (ammonia) proceeds from the blood, and proves a too-heating regimen, and the non-conversion of nitrogen into urea; there is, therefore, constant danger of typhus. The daily use of the Seidlitz salt will ward off that danger, without adding to the fixed bases, for the small quantity of magnesia which it deposits prevents colics, and neutralizes the acids of the intestine. This salt also agrees with dyspeptic persons.

The Chanteaud Seidlitz may replace, with advantage, the natural saline mineral waters.

Aciduric Diathesis.-The acid state of the urine, as Liebig has shown, proceeds from the acid phosphate of soda, rather than from uric acid, which is found in it as a neutral urate, and the salts of which are not soluble in cold urine, any more than uric acid itself.

Acidity of the urine may also be due to fixed organic acids, and more rarely to volatile fat-acids.

Urine with a strong acid reaction is generally much coloured,

the colour being brown, or reddish yellow. On cooling, it precipitates urates in abundance; its specific gravity is usually very high.

The abuse of mineral acids, and certain dyscrasias, such as rheumatic gout, are the most frequent causes of acid urine. The organic acids, on being transformed into alkaline carbonates, render the urine rather alkaline than acid.

Aciduria predisposes to uric acid and urate of ammonia calculi, and provokes vesical catarrh; thus it may be comprehended, how very important is the habitual use of the Seidlitz salt, in preventing grave diseases, which may attack the strongest constitutions. With the Chanteaud Seidlitz, these maladies will disappear.

I ought here to say a word concerning oxaluria, or the presence in the urine of oxalic acid, and the formation of oxalate of lime or mulberry calculi. This diathesis is the product of a starchy and saccharine alimentation.* The sugar not being completely burnt, is converted into oxalic acid. I have demonstrated this fact by feeding young dogs on starchy matters and sugar. In order to prevent this diathesis, a nitrogenous and saline diet is necessary. I must also speak concerning the necessity of common salt or chloride of sodium as an article of diet. A chemist, M. Bergé, has shown that without salt in the plasma of the blood, the fibrin, albumen, musculin, and ostéin, that is to say, all the nutritive juices of our blood and tissues, will solidify, and the red globules will be dissolved. These globules are decomposed in a solution of pure albumen, like as in distilled water, whilst albuminous water, containing only a hundredth part of common salt, preserves these globules perfectly, without alteration. When a man is deprived of chloride of sodium in his food, he becomes pale, chlorotic, and oedematous; his appetite fails, and the secretion of the saliva and of the gastric juice is diminished. Saline blood absorbs more oxygen, stimulates

*A warning to vegetarians.-H.A.A.

the chemico-physical act of nutrition of the tissues, and provokes the expulsion of the nitrogenous principles of regressive nutrition, through the kidneys, lungs, and skin. It is thus seen how very important a saline regimen is in the preservation of health.

Hæmoglobinuric Diathesis.-This diathesis is characterised by the presence in the urine of the colouring matter of the blood, and indicates a decomposition of the red globules. It has been observed in poisoning by carbonic oxide and by arsenuretted hydrogen, sulphate of copper, and chloral.

Spontaneous hæmoglobinuria is also observed, but more rarely. The Répertoire of 1873 relates a remarkable case of it. The young man who was affected with it was cured, thanks to the timely diagnosis which was made, and an appropriate treatment.

Hæmoglobinuria is distinguished from hæmaturia by its negative character; globules and fibrin being absent in the urine. The absence of albumen ought also to be noted, for no coagulum can here be obtained by chemical re-agents, which decompose the hæmoglobin immediately; acetic acid, for example. Acetate of lead, which does not decompose the hæmoglobin, does not even make the liquids turbid which hold it in solution. (Spring.)

a

The presence of hæmoglobin in the urine reveals itself by tenuous matter, resembling coffee-grounds, insoluble in ether. When the quantity of hæmoglobin evacuated by the urine is but small, the general health may not be much disturbed; but grave disorders may result when the quantity discharged is equal to several ounces of blood, instances of which Vogel has cited.

The hæmoglobinuric diathesis will be remedied by the arseniates of strychnine and of iron:

Three to six granules of each a-day;

and by a saline regimen, strengthening diet, and plenty of active exercise.