There are some special diets recommended. The skim-milk treatment of Donkin has been much used on the ground that the sugar of milk contained is assimilable in diabetes and does not form sugar. He says in this respect it is superior to casein, which does resist the sugar-forming process of the malady. Skim milk may be used, but is not a cure, and is poor food. Under certain conditions, for a time, it may do great good as exclusive diet. Von Noorden has recently recommended in certain cases that the patient live much on oatmeal gruel. Ask your physician about this. Von Noorden's oatmeal soup is made as follows: Oatmeal, 250 grams; butter, from 250 to 300 grams; any vegetable albumin, 100 grams. Take a portion of this soup every two hours, say a tea-cupful, and take no other food for from one to two weeks. This method is to check the formation of acetone bodies and thus prevent diabetic coma, so much to be dreaded in advanced cases. The theory is that if we admit carbohydrates to the diet we check the tendency to acidosis. Four days of this treatment would perhaps be better than two weeks, otherwise the increased sugar output in the; urine will indicate great injury being done. Potatoes and milk may have the same effect as the oatmeal. The idea is alternate giving and rest from carbohydrates.

Dr. Heinrich Stern, of New York City, opposes this treatment. He objects to oatmeal as causing disgust, and he does not approve of the butter. He thinks it yields acetone bodies, and in advanced cases these are dangerous. If we wish to suppress the acidosis without aggravating the diabetic condition, we can neither add carbohydrates to the nourishment for any length of time nor can we in most cases increase the amount of meats and such food. Therefore nothing remains but to turn again to the fats, - that is, such fats as contain a small amount of fatty acids of low molecular weight.

The fatty acids which may be considered mother substances of acetone bodies are valerianic, butyric, and caproic acids; fatty acids of high molecular weight, like palmitic, stearic, and especially oleic acids, yield comparatively little acetone. Hence, butter and cream are productive of largely increased acidosis, while lard, suet, and particularly olive oil, do not largely increase the acetone bodies. See the intricacies of these cases. I notice this matter to advise my readers of the necessity of competent medical supervision of all cases of diabetes. If we give a diet alone of meats and large amounts of suet, lard, or olive oil the patient would soon tire of this diet and his nutrition would not only not improve, but his digestive organs would become disordered. In these cases, Dr. Stern says, the great remedy is in the yolk of egg diet. The fats in egg yolk do not produce or increase acetone substances and do not cause disgust in the patient. The rationale of the egg cure is as follows, in Dr. Stern's words:

"1. Palmitin, stearin, and olein, the fat substances of the yolk, occasion but small amounts of acetone bodies; in the combination in which these fats exist in the yolk, they yield no butyric acid, or hardly any.

"2. The large amount of lecithin, supplied to the organism by the yolk, tends to the restoration of nerve force and the amelioration of the cachectic condition.

"3. The occurrence in the yolk of a diastatic ferment assisting in the conversion of amyloid substances introduced by proteids and allowed vegetables.

"4. The digestive secretions stimulating functions of the yolk. Where there is lack of hydrochloric acid in the digestive fluids egg yolk is a remedy." From what has been said of egg yolk and hydrochloric acid in digestion, this assertion may be questioned.

The "yolk cure" consists in ingesting from 30 to 40 yolks of hens' eggs per day, together with a small amount of proteids and the non-avoidable carbohydrates furnished by the latter and certain allowed quantities of green vegetables. As each yolk contains about 5 grams of fat, representing more than 46 calories, it takes about 21 yolks to furnish 1000, and about 32 yolks to make up 1500 calories. A diabetic weighing 60 kilos, ingesting 21 yolks a day, would therefore obtain in fat alone 16.6 calories per day per kilogram of body weight; taking 32 yolks a day, the average for each kilogram of his absolute weight would be 25 calories. Yolks sufficient to yield from 10 to 15 calories per day per kilogram of body weight however, are all that are necessary to be ingested in grave cases of diabetes complicated by acidosis. The "yolk cure," besides suppressing the acetone bodies, causes systemic and nutritive improvement, and increase of body-weight, vigor, and resistance. It also stimulates body growth in the diabetic child or adolescent. The "yolk cure" supplies but very small amounts of nitrogen. However, it is body albumin saving in a much higher degree than any other dietary regimen.

The technic of the "yolk cure" is quite simple.