Abstract
This fatal case of juvenile diabetic coma is reported because of the presence of several unusual features, namely, (1) the finding of only insignificant ketonuria in spite of extreme acidosis, (2) the presence of a large amount of acetone in the spinal fluid notwithstanding its absence from the blood, and (3) the failure of enormous doses of insulin to influence the blood sugar level. REPORT OF CASE The patient, a girl, aged 9 years, Jewish, was admitted in a state of coma to the United Israel Zion Hospital, Jan. 7, 1924. The family and past personal history were negative. The patient was in good health until three weeks prior to admission, when she began to suffer from increased frequency and volume of urination, pronounced thirst, itching of the skin and progressive loss of weight. Later she complained of slight disturbance of vision and headache, and two days before entering the

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