The name diabetes is derived from a Greek word, διαβαιυειν, signifying "to pass through," from the abundance of urine which is a special symptom of this disease. The term Glycosuria (γλυxυs, sweet, oupov, urine) has been proposed to be substituted for Diabetes by M. Bouchardat; and though it has the advantage of indicating what is an essential character of the malady - for no one would consider a case diabetic without the presence of sugar in the urine - yet it is to be remembered that the ancients knew nothing of this symptom, and they gave the name Diabetes to a certain assemblage of symptoms, of which the most prominent were increased secretion of urine, thirst, dry skin, gradual emaciation and loss of strength; again, as sugar, and often in considerable quantity, is present in the urine of patients, without any of these general symptoms, and also occasionally in those suffering from such diseases as congestion of the liver, diseased heart, or lungs, epileptic fits, gout etc., it is better to retain the name Diabetes for those cases, where with the presence of sugar in the urine general symptoms exist, and to limit the term Glycosuria to those cases where sugar is present in the urine unaccompanied by general symptoms and which, therefore, would not be treated as cases of Diabetes; the presence of the sugar being considered as an accidental complication, arising, most probably, from disturbance of the functions of the liver.

In giving a short history of the various theories that have been formed as to the nature of this disease, I shall confine myself chiefly to those which have suggested new modes of treatment, which, from the advantages derived, have outlived the theories from which they originated.

The ancients designated every disease by the name of Diabetes in which with an increase of urine there was thirst, progressive wasting and loss of strength; but as they were almost entirely unacquainted with Pathological Anatomy and Chemistry, Diabetes was placed by them under the class of diseases called "Phthisis," which included all diseases the main characteristic of which was wasting, the cause of the wasting making no difference as to the classification.

The chemical theories, as to the nature of Diabetes, date from the observations of Willis, who, in 1674 noticed that the urine of a diabetic patient had a sweet flavour. Cowley in 1778 separated the sugar from the urine. Dr. Rollo in his work on Diabetes (1797-8) argued that from the symptoms and effects it consisted in a disorder of the stomach proceeding from a morbid change in the powers of digestion and assimilation; that this change consisted in an increased action and secretion with vitiation of the gastric juice, and probably of too active a state of the lacteal absorbents; that the sugar of the disease is formed in the stomach chiefly, if not entirely, from the vegetable matter taken as food, and that the kidneys and other parts of the system, as the skin, are affected secondarily. He therefore conceived that cutting off all the supplies of vegetable matter taken as food was the rational mode of treatment, hereby laying the foundation of the restriction of diet, which at the present time is still most beneficially employed. Dr. Rollo considered that by regimen and medicine you could prevent the formation of sugar, and diminish the increased action of the heart, and that the best means to effect this object were repose, an entire abstinence from vegetable matter and the use of emetics, narcotics etc.

Early in this century Nicolas and Gaudeville looked on this disease as arising from an intestinal affection, in consequence of which the chyle instead of being composed of nitrogenous matter, consisted of less perfectly elaborated elements of saccharine matter and not fitted for the nutrition of the body.

In 1837 McGregor detected sugar in the blood; he also discovered it in the matter vo-mitted by a diabetic patient, who had been fed for three days on roast beef and water: he, therefore, considered as Rollo did, that the fault was in the digestive organs; that what ought to be converted into healthy chyle was changed into saccharine matter and, entering into the circulation, was excreted by the kidneys.

Supported by the authority of Rollo, Nicolas, and Gaudeville, M. Bouchardat (Annuaire 1841) gave the following views of Diabetes. The existence of sugar in the urine has its origin in the transformation of amylaceous matter, taken as food, into sugar such as we can effect in our laboratory, that there exists in diabetes a principle which has on starch an action similar to that of diastase: he further asserted that in all the diabetic patients he had seen, the quantity of sugar contained in the urine was in direct ratio to the quantity of starchy aliment and sugar they took; if the quantity of amylaceous elements and sugar was diminished, the quantity of sugar in the urine was diminished in like proportion: that the thirst of a diabetic patient is always in direct ratio to the sugar and amylaceous matter taken: he observed, he says further, that for a quantity of food representing a pound of starchy matter the patient drank ordinarily about twelve pints of water and passed about fourteen pints of urine: he explained the ardent thirst which torments the patient by a fact which is well known chemically, that for the complete change of starchy matter into sugar it must be dissolved in about seven times its weight of water; a similar phenomenon takes place in the diabetic patient in order that the transformation of starch into sugar may take place, hence the terrible, irresistible thirst. In a memoir published in 1846, he says, on causing a diabetic patient to vomit one hour after a meal of starch, and examining the vomited matter, he found sugar; by further analysis he discovered a substance composed of Oxygen, Hydrogen, Carbon, and Nitrogen, which he considered to be the diastase, capable of transposing starch into sugar in the stomach: on the contrary, in a sound man, the vomited matter contained no such substance two hours after a repast of starchy matter, and a very small proportion of glucon or sugar. In Annuaire 1846 (supplement p. 199), he considered that the digestion of a diabetic patient differed from that of a sound man in that the transformation of amylaceous matter in the one. was rapid, taking place in the stomach, whilst in the latter it was slow, taking place in the intestines; and that the principal cause of diabetes was an abundant use of amylaceous matter, and a more rapid formation of sugar with its consequent introduction into the circulation, more being absorbed at one time than can be assimilated. I have enlarged upon the views both of Dr. Rollo and M. Bouchardat, as I consider them representatives, the one in England, the other in France, of the stomachic origin of diabetes, and it is wonderful how closely their dietetic treatment of the disease corresponds-Bouchardat introduced into France the system of dieting the patient, from which great benefit was derived; he also invented a gluten bread which goes by his name and is the diabetic bread in use there. By this treatment, - the complete abstinence from sugar and starch, - Bouchardat said, in 1838, that after twelve hours the thirst abated, the urine gradually became normal, the appetite restrained within its ordinary limits, and the health became reestablished. But in 1841 we find him speaking very differently, for he confesses that three patients, whom he had considered cured, died; and what showed also that the sugar in diabetes had another source than the starch and sugar taken as food, was the relation by M. Leblanc, veterinary surgeon, at a meeting of the Academy of Medicine, of the case of a dog six and a half years old, which had been fed all its life on raw beef and yet suffered from diabetes. Dr. Prout, however, states that he never saw a case of diabetes in one of the lower animals. But the question was soon asked why it was, since sugar and amylaceous food are constantly taken, the diabetic patient alone eliminated sugar. The same answer was given by M. Mialhe (Academie des Sciences, 1843), and M. Alvaro Reynoso (Memoire sur la presence du sucre dans Ies urines, Victor Masson, 1853). Mialhe said that sugar was destroyed in a sound organism by the alkalinity of the blood, but that in a diabetic patient the blood is too little alkaline, or even acid, and so the sugar could not be destroyed; this was the origin of the alkaline plan of treatment, to increase or restore the alkalinity of the blood; it was the consequence of Mialhe's theory, and though this theory is wrong as to the reaction of the blood, for it has been proved that the serum of the blood in diabetes is as alkaline as that of healthy blood, and that even a fluid more alkaline than the blood could not decompose glucon, yet the treatment has been followed by very remarkable results. Valleix says of this theory, that it is as complete, as satisfactory to the mind, as is permitted man to make; it is also to be looked upon as founded upon the sure basis of facts. (Bulletin de Therapeutique, 1845 Vol. xxx.)