This was formerly very unfavourable, indeed Nasse said that an individual who found his urine increase largely in quantity and have a sweetish taste and smell ought to make his will. Now it is more favourable; it varies however according to circumstances. If a case is called Diabetes simply from the presence of sugar in the urine without general symptoms existing, it is easily cured, and I am sure many of the so called cases of Diabetes are of this kind. In infants whilst teething, in fits of hooping cough, of asthma, etc. we find the sugar disappear as the cause on which it depends disappears. The sugar resulting from disturbance, injury, or other alteration of the nervous system is dangerous in relation to the cause. When the Diabetes has not existed long, when the sugar disappears quickly from the urine and with this disappearance the general symptoms improve in an equal ratio, we may augur favourably: on the contrary if the affection be of old date, when the symptoms have been very pronounced and the sugar is abundant, though we may have a great amelioration of the symptoms, we must be cautious in our prognosis, as relapses in such cases are very frequent, and complications are apt to occur and carry off the patient unexpectedly. The disappearance of the sugar, without a corresponding amelioration of the general symptoms, is by no means a sign of improvement even in recent cases, much less in cases of long standing: indeed the disappearance of the sugar is often a sign of a grave complication. The appearance of albumen in the urine is a very dangerous symptom; indicating probably a congestive state of the kidney, commencing organic alteration of their structure from excessive work: M. Rayer considered it a sign that dropsy is threatened. I have only seen three cases of this kind, but dropsy did not follow. Age has a grave influence on our prognosis. Infants and young adults, if the disease is severe, for the most part, die rapidly: in elderly people, that is to say above the age of 45, the prognosis is more favourable, more especially if they are in easy circumstances, M. Bouchardat considered that when there was no tubercle in the lungs, the female had a better chance of recovery than the male. As the patient generally dies from exhaustion, unless some accidental complication occurs, we must regard loss of weight and power with great anxiety; and a dry cough followed by expectoration, with dulness on percussion of the upper part of the chest and morning perspirations, as fatal symptoms. In cases where complications occur we must be very careful in our prognosis, however slight the symptoms may be, as patients often very suddenly and unexpectedly sink.

Finally, in estimating the danger of Diabetes, it is not entirely the quantity of sugar contained in the urine which must guide us, but the quantity retained in the system, which we can discover by an examination of the assemblage of symptoms. We must examine the muscular strength, the state of the skin, the digestive functions, respiration, calorification, the nervous system; we must ascertain also the weight of the patient and see if he is gaining or losing flesh, and the amount of deposit from tannin or solution of sulphate of zinc.

By a due consideration of all these symptoms, together with the quantity of sugar in the urine, shall we alone be able to come to a right prognosis of the disease.