Diabetic coma was first reported in the literature as a separate entity in 1828, when it was described by Stosch; it was later (1854) described by von Dusch, of Germany, and Marsh, of Scotland. However, it remained for Kussmaul, of Strasbourg, twenty years later, to give the classic picture, in which he described the characteristic breathing, thegrosse Athmung, which today bears his name and remains as perhaps the most pathognomonic clinical sign. Prior to the memorable discovery of insulin by Banting and his associates in 1921 and its successful commercial preparation one year later, diabetic coma presented one of the most hopeless catastrophes of modern medicine. Before 1922 few writers had the courage to review a series of cases of diabetic coma with its disheartening mortality, but with the advent of insulin the situation assumed a right-about-face, and a number of excellent surveys have appeared. Notable among these surveys