Strain and shell-shock: Acceleration of diabetes mellitus.
Case 140. (Karplus, February, 1915.)
An infantryman, aged 22, previously healthy and from a healthy family, was struck by a shell fragment in the forehead and lay for several hours unconscious. He did not vomit. He had a number of furuncles on his body and his urine, upon examination, showed a severe diabetes mellitus which increased despite treatment. Upon an attempt to withdraw carbohydrate, the sugar suddenly sank from six to four per cent. Acetone at the same time increased. An abrasion had been noticed by the patient a few days before the shell explosion on the spot rubbed by the tornister. The patient said that since his accident he had had to urinate every night several times and was often very thirsty, neither of which tendencies had he had before. A month before he became merod he had had an injury of the hand produced by a shell fragment. He had undergone tremendous strain.
The chances are that the excitement and the strain had more to do with the diabetes mellitus than the shell explosion.