GEORGE SMITH
A CASE OF DIABETIC COMA
J.S. (sic), aged 26, a navvy on the tramp , was brought into the Newbury Union Infirmary on February 28th.
In the course of a few days he was found to be suffering from diabetes. He could give no account of the duration of the disease, and did not seem to view his extreme thirst or the large amount of urine he passed as anything unnatural. He was dieted on milk, beef-tea, eggs, meat and green vegetables. Once during the month of March, he was very drowsy for three or four days. This, however, quite passed off.
On April 20th he was again very drowsy, being roused with difficulty. This drowsiness gradually passed into a state of coma, in which I found him on April 23rd, at noon. He was at that time lying on his back in a state of profound coma. His mouth was partially open; there were sordes (sic) on the teeth. The breath was very offensive, but it had a distinctly sweet odour, being likened by the nurse to the smell of burnt sugar. The eyes were partly open; the conjunctivae insensitive to the touch; the pupils small and equal, not acting to light. The body was warm to the touch, the temperature in the axilla being 99.4 ºF. The radial pulse was imperceptible; the heart's action was extremely weak, being 128 in the minute. The breathing was peculiar, being deep and sighing for several successive inspirations, and then almost imperceptible for many seconds. About a pint of urine was drawn off by the catheter, and it presented the following characteristics. It was light in colour, specific gravity 1016; the presence of sugar was shown by both Trommer's and Moore's tests; there was a slight trace of albumen; the addition of liquor ferri perchloridi made the whole of the urine milky, and gave rise to a brown colour at the bottom of the test-tube. The treatment I adopted was to inject warm water into the rectum; but the patient died twelve hours afterwards.
ROBERT BIRCH, L.R.C.P., Newbury,Berks.
The British Medical Journal May 6 1883
George Smith – BMD Deaths Jun Q 1883
Workhouse records; died April 24th 1883.
Burial records – buried 27 April 1883
