If it weren't so true and ancient, this Definition of Diabetes might be humorous. What is tragic is that in nearly 2,000 years since it was written, we have made so little progress in treatment or cure work and still identify Diabetes Mellitus in nearly the same terms!

The following was written by Areteus the Cappadocian, sometime in the second to third century AD.

This is from Dorothy Clark's "Source Book of Medical History," originally published in 1942, and republished in 1960 by Dover.

She cites as her source a translation of a Greek version done by Francis Adams in 1856 for the Sydenham Society.

Diabetes is a wonderful affection, not very frequent among men, being a melting down of the flesh and limbs into urine. Its cause is of a cold and humid nature as in dropsy.

The course is a common one, namely the kidneys and bladder; for the patients never stop making water, but the flow is incessant, as if from the opening of aqueducts.

 The nature of the disease then is chronic, and it takes a long period to form, but the patient is short-lived if the constitution of the disease be completely established; for the melting is rapid, the death speedy.

Moreover, life is disgusting and painful; thirst unquenchable; excessive drinking, which however is disproportionate to the large quantity of urine for more urine is passed; and one cannot stop them either from drinking or making water. Or if for a time they abstain from drinking, their mouth becomes parched and their body dry; the viscera seem as if scorched up; they are affected with nausea, restlessness, and a burning thirst; and at no distant term they expire, thirst as if scorched by fire.

But by what method could they be restrained from making water? Or how can shame become more potent than pain?

 And even if they were to restrain themselves for a short time they become swelled in the loins, scrotum and hips; and when they give vent they discharge the collected urine, and the swellings subside for the overflow passes to the bladder.

If the disease be fully established, it is strongly marked; but if it be merely coming on, the patients have the mouth parched, saliva white, frothy, as if from thirst (for the thirst is not yet confirmed), weight in the hypochondriac region.

A sensation of heat or cold from the stomach to the bladder is, as it were, the advent of the approaching disease; they now make a little more water than usual and there is thirst but not yet great.

But, if it increase still more, the heat is small indeed, but pungent, and seated in the intestines; the abdomen shrivelled, veins protuberant, general emaciation when the quantity of urine and thirst have already increased; and when, at the same time, the sensation appears in the extremity of the member, the patients immediately make water.

Hence the disease appears to me to have got the name diabetes, as if from the Greek word which signifies a siphon, because the fluid does not remain in the body, but uses the man's body as a bladder whereby to leave it. They stand out for a certain time, though not for very long for they pass urine with pain, and the emaciation is dreadful; nor does any great portion of the drink get into the system, and many parts of the flesh pass out along with the urine.

The cause of it may be that some of the acute diseases may have terminated in this; and during the crisis of the disease may have left some malignity lurking in the part.

It is not improbable also, that something pernicious, derived from other diseases which attack the bladder and kidneys, may sometimes prove the cause of this affection.

But if anyone is bit by the dipsas [a species of viper] the affection induced by the wound is of this nature; for the reptile, the dipsas, if it bite one, kindles up an unquenchable thirst. For they drink copiously, not as a remedy for thirst, but so as to produce repletion of the bowels, by the insatiable desire of drink. But if one be pained by the distention of the bowels and feel uncomfortable, and abstain from drink for a little, he again drinks copiously from thirst, and thus the evils alternate; for the thirst and the drink conspire together.

Others do no pass urine, nor is their any relief from what is drank. Wherefore, what from insatiable thirst, an overflow of liquids, and distention of the belly, the patients have suddenly burst.

TREATMENT

The affection of diabetes is a species of dropsy, both in cause and condition, differing only in the place by which the humour runs. For, indeed, in ascites the receptacle is the peritoneum, and it has no outlet, but remains there and accumulates. But in diabetes, the flow of the humour from the affected part and the melting are the same, but the defluction is determined to the kidneys and the bladder; and in dropsical cases this is the outlet when the disease takes a favorable turn; and it is good when it proves a solution to the cause, and not merely a lightening of the burden. In the latter disease the thirst is greater; for the fluid running off dries the body.

But the remedies for the stoppage of the melting are the same as those for dropsy. For the thirst there is need for a powerful remedy for in kind it is the greatest of all sufferings; and when a fluid is drunk it stimulates the discharge of urine; and sometimes as it flows off it melts and carries away with it particles of the body. Medicines then which cure thirst are required, for the thirst is great with an insatiable desire of drink, so that no amount of fluid would be sufficient to cure the thirst. We must, then, by all means strengthen the stomach, which is the fountain of the thirst. When, therefore, you have purged with the hiera, use as Epithemes the nard, mastich, dates, and raw quinces; the juice of these with nard and rose oil is very good for lotions; their pulp with mastich and dates, form a cataplasm....

But the water used as drink is to be boiled with autumn fruit. The food is to be milk, and with it cereals, starch, groats of spelt, gruels. Astringent wines to give tone to the stomach, and these but little diluted, in order to dissipate and clear away the other humours; for thirst is engendered by saltish things.