A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Science
A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Medicine -- Practice
DURATION.--Diabetes is a disease of which the duration is measured by
months and years, and although cases are reported in which death
supervened in from six days to six weeks after the recognition of the
disease, it is evident that such periods do not necessarily measure its
actual duration. The disease may have existed some time before coming
under observation. On the other hand, a case is reported by Lebert
which lasted eighteen years; another, under the successive observation
of Prout and Bence Jones, sixteen years; and a third, under Bence Jones
and Dickinson, fifteen years. The younger the patient the shorter
usually is the course run and the earlier the fatal termination. Yet I
have known a girl of twelve recover completely. After middle age the
disease is usually so easily controlled by suitable dietetic measures,
if the patient is willing to submit to them, that its duration is only
limited by that of an ordinary life, while carelessness in this respect
is apt to be followed by early grave consequences.
COMPLICATIONS.--The almost sole complication of diabetes mellitus is
the tubercular phthisis which so often terminates it. Indeed, it is
doubtful whether this complication should not be regarded as a
consequence, as should also the boils, gangrenous processes, and
ophthalmic conditions which have been mentioned under Symptomatology.
Jaundice has occurred three times in my experience up to the present
time. Senator says that when not an accidental complication due to a
catarrh of the duodenum it may result from compression of the biliary
capillaries by the overloaded blood-vessels and enlarged gland-cells of
the liver. In one of my cases, in which jaundice appeared to be the
initial symptom, but which disappeared some months before death, the
autopsy revealed atrophy of the liver. It is well known that pancreatic
disease, especially cancer, is apt to be accompanied by jaundice, and
as pancreatic disease is often at the bottom of diabetes, it will
similarly account for the jaundice, while the presence of jaundice may
also suggest a pancreatic diabetes.
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