A Case of Fatal Diabetic Coma Without Diacetic or Beta-Oxybutyric Acid

This case of fatal diabetic coma without either diacetic or beta-oxybutyric acid in the urine seems of sufficient interest to be placed on record, because of the general tendency to trust to the Gerhardt reaction as a sign of impending coma in cases of diabetes.1 History. —Mrs. H., aged 53, hairdresser, referred by Dr. Jackson of Hicksville, Ohio, entered St. Joseph Hospital Nov. 5, 1913. The family history was entirely negative. The patient's health had always been good. She had typhoid fever at 16 and again (?) at 43, and pneumonia at 45. There had been no other severe illnesses. Menstruation began at 16; there had been two pregnancies; one resulted in a miscarriage at three months, and there is a son living at 33. The menopause occurred at 49. The patient's health has been good during and since, until the beginning of the present illness. Two months ago the