A treatise on Bright's disease and diabetes, with especial reference to pathology and therapeuticsIncluding a section on retinitis in Bright's disease . ense a fluid as the blood under these cir-cumstances without some resistance to its onward resistance might be afforded by the viscidity of the sugar-laden blood. On the other hand, we can conceive the inges-tion of fluid by reason of thirst to be so large that the kidneys DIABETES MELLITUS. 265 cannot, with sufficient rapidity, eliminate it; whence a filtra-tion of it into the tissues. The term diabetic coma has been applied to
A treatise on Bright's disease and diabetes, with especial reference to pathology and therapeuticsIncluding a section on retinitis in Bright's disease . ense a fluid as the blood under these cir-cumstances without some resistance to its onward resistance might be afforded by the viscidity of the sugar-laden blood. On the other hand, we can conceive the inges-tion of fluid by reason of thirst to be so large that the kidneys DIABETES MELLITUS. 265 cannot, with sufficient rapidity, eliminate it; whence a filtra-tion of it into the tissues. The term diabetic coma has been applied to a form of comawhich sometimes is the immediate cause of, or at least imme-diately precedes, death. The condition is one of suddenly orgradually supervening unconsciousness, with or without pre-vious irritability or uneasiness. Convulsions do not addition to coma there are frequent and feel)le pulse, rapidand deep inspiration. It has been variously ascribed to poison-ing by sugar, acetone, alcohol, or other unknown substances,and by Professor Sanders and D. J. Hamilton* to slow car-bonic acid poisoning due to fat embolism of the pulmonary. a, Supposed fatty emboli in the capillaries of tha luns;, stained black by perosmic acid ;6, oblong, branching masses of the same; c, transverse sections of arterioles showingglobules of fat among the blood-corpuscles. vessels, the result of lipoemia. In Dr. Starrs case of diabetes,alluded to on p. 261, a careful study by Dr. J. H. C. Simes ofsections of the lung, treated by perosmic acid, demon-strated the fact that the pulmonary bloodvessels were occludedby fat emboli, as shown in Fig. 36. But as Dr. Starr cor-rectly says, the share of the embolism in producing the coma * Edinburgh Med. Journ., July, 1879. The conclusions of these gentle-men were based upon the clinical histories and the results of the post-mortem 2G6 DIABETES. and death of the patient is very uncertain, since on accountof his debilitated condition a croupous pneumo
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