( Originally Published 1921 )
In explaining to a person the nature of glycosuria I said: "You are suffering from a severe pain that comes from the heart whenever you try to do anything, and sometimes you feel the pain when you are not doing anything. Your blood pressure is high over 200 at the present moment.
"You have developed this trouble gradually and have been through a severe ordeal. You have had a lot of operations on your face to relieve the catarrhal condition situated behind your eyes and the frontal sinus. You have suffered much and worried much, and it has upset your whole system, particularly the chemistry of your body. Your food, instead of nourishing you, became a poison to you, and this caused certain injury to your heart and to the blood vessels and kidneys. In other words, it put your whole machinery out of order and also destroyed its texture. Instead of being soft and pliable, your blood vessels are somewhat stiffened and hardened, so that the machine does not work easily it works only under pressure.
"Among other things, your system was so upset that you got sugar in the urine diabetes, you call it. It probably is not true diabetes. It is more likely just sugar in the urine. There is a distinction between the two. The person who has diabetes gets thin and passes a quantity of water; he is feeble and has sores on his legs, and so on. You have probably known people who have died of true diabetes. It is an entirely different disease from what you have.
"The same disturbance of your system that led to the injury to your circulatory organs also led to this glycosuria from the same underlying causes. They both come from worry and hardship, and so on.
"I see, during the course of my work, many people with your trouble. That is my special work. I know that the right thing to do is for the time being not to treat the sugar, to watch it carefully, indeed, to see that it does not increase too much, but to leave it out of the question and to put you on a diet which seems to be wrong but which experience has taught me is right.
"In other words, you must eat a certain amount of starchy foods and you must keep away from meat, eggs, and fish. You must live more or less on green vegetables and starchy things, which are supposed to be bad for your diabetes.
"As everybody knows, a person with true diabetes must not eat much starch. There is no reason to eat sugar, as your system can get all the sugar it needs by making it up out of the starch. So sugar as such should be avoided by eating a certain amount of bread, vegetables, milk, cheese, and things like that. The diet is an important part of the treatment.
"We have to start with a clear intestinal tract, so I am going to give you serial doses of castor oil and some nitroglycerin pills which you have to learn to use. The nitroglycerin is taken in small doses, and you have to learn to use it to keep yourself free. from pain. You take one of these little pills and chew it but don't swallow it, as it acts by absorption in the mouth. Take one of these pills whenever you have a pain or are afraid you are going to have one. Keep away from pain as much as possible, because the more of this pain you have the more you will have as the nerves become irritated.
"The first thing to do is to get you so that you are more comfortable; the next thing is to get you so that you are really better. The two things will go together, but it takes more time to cure than it does to relieve.
"The disease which you have has ordinarily no symptoms. There is no suffering connected with it. Most people with it go ahead feeling perfectly well, and then suddenly have some-thing serious happen to them. The pain is given to you to warn you that you have the trouble and to make you take care of your condition."