It is so seldom in general practice that sugar is found in the urine, other than in diabetes mellitus, that reference to its probable occurrence only will be made here. The subject is fully treated under the above title. Sugar is normally present in small quantity in the blood, and the assertion has been made that it is present in normal urine. This has been discussed pro and con. There is much doubt as to whether it is so found except as the result of disease. Independent of diabetes it is found in those forms of chronic nervous disease which involve the medulla oblongata and the floor of the fourth ventricle. It occurs from intense mental activity, violent grief and anxiety, and during apoplexy, epilepsy, and as the result of cerebro-spinal meningitis; also from direct injury to the spinal cord or brain. It may occur in an intermittent or paroxysmal form in cholera, yellow fever, severe malarial fevers, typhus and typhoid; in the eruptive fevers and diphtheria, whooping cough, chronic bronchitis and cirrhosis of the liver.
Certain medicinal agents induce it, also, such as alcohol, hydrocyanic acid, turpentine, mercury, arsenic, salicylic acid; the most of the coal tar derivatives, morphin, chloral hydrate, atropin and others.
Diagnosis:—The diagnosis is made in the same manner as described under diabetes mellitus. When albumin is found present in the urine, it should be precipitated before the tests are made.
Prognosis:—The prognosis is good in transient cases, the condition disappearing with the removal of the cause.
Treatment:—In the treatment, each condition which acts as a cause must have careful attention in the lines elsewhere prescribed. The patient should have out of door exercise when the strength permits, and should be happily environed. His diet should be largely of animal food, with the exception of those which contain sugar. The medicinal treatment will be largely symptomatic. Of medicinal agents hydrastis, conium maculatum and opium have been in common use; iron will always be of some service. I have obtained better results from syzygium jambolanum than from any other one remedy. I have given from five to fifteen grains of the powdered seeds every two hours for long periods. Bromid of arsenic will be found a good remedy also. Goss recommended rhus aromatic. I have not had success with it, but it deserves further trial in a condition like this, in which our medicinal resources are limited.