DIABETES

the rapid accumulation of new facts which has increased our knowledge of diabetes mellitus makes it difficult to give a comprehensive definition of this disease. diabetes is a condition in which the body is unable to metab- olise sugars efficiently. it is believed that this condition is pro- duced when there is insufficient available insulin in the body. the first suggestion that the pancreas is necessary for the complete utilisation of carbohydrates in the animal body was made by brunner in 1682. the relationship of the pancreas to diabetes was first suggested in 1788 by cowley, an english dew ar—diabetes physician. in 1889 von mering and minkowski showed that the complete removal of the pancreas from animals resulted in a condition which is practically identical with diabetes mellitus inman. although attempts were made to secure an anti-diabetic substance from the pancreas by scores of investigators, this sub- stance was not proven to be present until 1921 (see insulin). diabetes mellitus is a very common disease. it has been stated that it occurs in 1% of the population of the united states. the cause of the disease is not definitely known. there are probably numerous factors which predispose to its develop- ment. it is not hereditary in the strict sense of the word. it is quite possible that certain children are born with insufficient in- sulin-producing tissue. infection in the region of the pancreas seems to play a definite part in the aetiology of the condition. in elderly patients vascular sclerosis may be a factor. obese individuals are more liable to develop diabetes than those whose weight is within the proper limits. in a few cases it appears probable that an injury in the region of the pancreas was the predisposing factor. symploms.—the untreated diabetic patient suffers from ex- treme thirst, hunger, loss of weight and strength. he excretes abnormally large quantities of urine. he is very susceptible to infection and this condition, when established, is difficult to eliminate. the diabetic is unable to burn sugar. this sugar accumulates in the blood and is excreted in the urine. not only are the sugars imperfectly metabolised, the fats are also not utilised in a normal manner and certain products of their ab- normal or incomplete decomposition accumulate in the blood and produce the conditions of acidosis and coma. the diabetic condition is suspected when a patient complains of one or more of the symptoms or signs mentioned above. an analysis of the urine for sugar should always be made. diabetes may be present and sugar may be found in the urine when the patient is not aware of any of these symptoms. the routine analysis of the urine in life insurance examinations has resulted in the early diagnosis of many cases of diabetes. the prognosis of the early case is, of course, much better than the advanced case since treatment can be instituted earlier in the disease. the amount of sugar in the blood, under certain standard conditions, is a valuable indication of the severity of the disease. the presence in the urine of the acetone bodies formed from the ab- normal breakdown of fats is a warning that acidosis or coma is imminent. the presence of these substances in the body can sometimes be suspected by the characteristic odour which they impart to the breath. treaimeni.—patients suffering from diabetes mellitus are treated by dietetic measures, and if the condition is severe, by the administration of insulin. before the discovery of insulin the methods of treatment introduced by allen and joslin of drastic restrictions in diet prolonged the lives of many severe diabetics. in many cases the necessary restriction in diet was so severe that marked under-nutrition was produced. under- nutrition renders the patient more susceptible to other diseases. several important principles underlie the dietetic treatment of this disease. the dict must supply sufficient calories to the pa- tient in order that his weight may be kept constant at the proper level. protein, preferably as lean meat, eggs or milk, must not be reduced below a certain minimum value. if this substance is unduly reduced, the tissue protein of the patient’s body is utilised. the carbohydrates and fats of the diet must be in a certain fixed proportion to each other. if the fats are present in excess of this proportion, there is danger of the production of the poisonous acetone bodies. in calculating the sugar in a diet, it is necessary to remember that sugar is formed from protein and to a lesser extent from fat, as well as from the carbohydrate of the diet. the diabetic patient is given as much sugar-forming food as he can utilise. sugar in excess of what is utilised is excreted in the urine. the amount of excess sugar can there- fore be determined by analysis. dietetic afeasures.—the diabetic diet should consist as far as possible of easily available seasonable foods along the line of anormal diet. it is much more satisfactory for the patient to diaghilev—diagnosis obtain the essentials of his diet from among these natural foods than to be dependent upon specially prepared diabetic foods. patients have been known to discontinue treatment because of the monotony of their diet. the diabetic diet need not be monotonous. . mild cases of diabetes can be successfully treated by dietetic measures. ifa patient excretes sugar on a diet which is sufficient only for his needs insulin must be supplied. the amount neces- sary is proportional to the severity of the disease. insulin, which is distributed as a sterile, watery solution, is administered hypo- dermically. it is not effective when given by mouth. insulin is usually administered twice a day, 15 to 30 minutes before break- fast and again before the evening meal. however, there is con- sidcrable variation in the different clinics on this point. some patients require only one dose per day, while in very severe cases three doses are necessary. if the diabetic patient is using a diet which is too high in fats or too low in sugar, coma may develop. <a large percentage of diabetics died of coma before insulin was discovered. the treat- ment of coma was to put the patient to bed, to supply fluids and alkalis, heat and stimulants and to give sugar by mouth or into avein. these measures are still necessary. insulin has proved.a specific drug in the treatment of this condition and, when ad- ministered sufficiently early, and in large doses, the results have been very successful. insulin is a very powerful drug. <a very scrious condition may be produced by the administration of an overdose. this may be avoided on the physician’s part by a very careful balancing of diet against dosage of insulin employed, and on the patient’s part by a close and intelligent observance of the diet, together with a thorough understanding of the premonitory symptoms of a beginning hypoglycaemic reaction. these symptoms of slight hypoglycaemia are sudden hunger, fatigue, a peculiar restlessness often described by the patient as a feeling of “ inward trembling,” pallor or flushing of the face, and an increased pulse rate which is a valuable sign in children. if the overdose of insulin is large and corrective measures are not taken, the patient may show pro- fuse perspiration, tremor, emotional disturbances, collapse and unconsciousness. the treatment of mild degrees of hypogly- caemia consists of the administration of carbohydrate in any convenient form, such as sugar candy. should the more serious symptoms develop, orange juice with sugar added, or corn syrup, may be given by mouth. in the very severe cases, sterile dextrose is given intravenously. in the past, less than 20° of patients suffering from severe diabetes lived more than 1o years. children, who usually have the disease in a severe form, seldom lived for more than 6 years. the diabetes which develops in individuals over 50 years of age is usually mild and the patients may live their allotted span of years. it is not possible to state definitely as yet the exact effect of insulin on diabetic mortality. it is certain, however, that thousands are now alive who would have died had it not been for insulin. in some cases it appears that patients need less insulin than they required when treatment with the material was commenced. in the great majority of cases, however, the insulin requirement has not been markedly reduced. the severe diabetic receiving insulih is now able to live practically a normal life, but the insulin treatment cannot be discontinued. | | (c. il. b.) diaghilev, sergei pavlovich (187 2- ), russian bal- let producer, was born in the province of novgorod, russia, march 19 1872. after studying law and music, he organised art exhibitions in st. petersburg (leningrad). in 1899 he founded the review fir tskusstra {the world of art), to which somov and bakst contributed, and which exercised a powerful influence on russian art. irom 1907 onwards he occupied himself with musical and theatrical productions and organised a number of russian concerts in paris; there he produced in 1908 and 1909 russian operas (boris godunov and the maid of pskef) and ballets. subsequently he organised successful ballet and opera seasons in london, paris, berlin, america and elsewhere, many of his productions being of amazing beauty. one of his most 851 successful operatic productions was that of moussorgsky’s aho- vanshichina. in england the originality of his conceptions may be said to have effected a revolution in choreographic art, and further put new life into stage dancing, which by the end of the roth century had degenerated into a spectacular show of little artistic significance. among his numerous successful ballets may be mentioned la boutique fantasque (1919), a charming fantasy composed of oddments from rossini’s note books; choreographic versions of stravinsky’s le chant du rossignol (1920), and pe- troushka; le pavillon d’armide (with decoration by alexandre benoit); and scheherazade by rimsky-korsakov (1910). in 1904 m. diaghilev produced a valuable book on the painter levitsky. a collection of photographs and drawings illustrating the ballet, les biches, was published in 1924 by b. koshno. diagnosis (greek esayrwous, a means of distinguishing), or the process of identifying the disease by consideration of the history (azammesis), symptoms, physical signs and examination in everv way of the patient, includes differential diagnosis or its distinction from other diseases. ? importance in treatment. diagnosis 1s essential for rational treatment, for without a knowledge of its cause treatment of a morbid symptom is merely empirical or, as it is often called, symptomatic, and, if beneficial, is so for the time being only and is not curative. the ideal of diagnosis is the discovery, as early as possible, of the disturbing factor at work, so that it may be removed or neutralised before structural damage results. in most diseases symptoms precede the signs or evidence of organic change in the body; but correlation of the earlier symptoms with the later physical signs indicating the presence of structural change has made it possible to predict the nature, course and proper treatment of the disease. this knowledge is more advanced in acute than in chronic dis- eases, in which the processes are less obvious and may be more complicated. it is therefore important to study the earliest mani- festations of disordered function and by keeping the patient under observation to collect data for the recognition of the begin- nings of chronic disease. this was one of the objects of the st. andrews clinic inspired and opened by the late sir james mackenzie in t919. diagnosis is a logical process based on all the available data and is the outcome of their analysis in the light of knowledge gained by experience; diagnosis therefore leads to prognosis. methods and symptoms.—diagnostic methods include investi- gation of the patient’s past history and of his environmental conditions, of the symptoms of which he complains, and method- ical examination of the patient and of his organs and of the man- ner in which they are performing their functions. this examina- tion 1s physical and physiological; an example of the physical signs is a tumour which can be felt; the physiological method is scen in the estimation of the functional efficiency of the heart or nervous system by means of exercises or special tests. physical examination detects gross organic changes; functional tests reveal the disordered action of the organs, which is present in the earlier stage of symptoms without physical signs, namely before struc- tural damage has been produced. but it must be admitted that the sequence of symptoms first and bodily changes with physical signs later is not invariable; for a slow change in the organs or tissues of the body may be accompanied by compensatory processes so complete as to pre- vent any functional impairment; thus an innocent tumour may grow to considerable size before it produces any symptoms, which may then be mechanical. a patient’s past history is important not only as regards boclily illnesses, but with reference to mental experiences which having become subconscious memories may be responsible for neurosis; freud and his followers, by means of the method of psycho-analysis (see psycio-analysis) have brought the trauma buried in the subconscious into the field of consciousness when other psychotherapeutic means can be employed. : use of physical signs.—physical signs, in contradistinction to subjective symptoms of which the patient complains, are ob- served by the medical man. first, inspection in a good light may 852 give a shrewd idea of what is the matter—for example severe anaemia, the pigmentation of addison’s disease, the cachexia of advanced malignant disease, the bony changes in acromegaly, the swollen features of myxoedema and cretinism and the shrivelled, sharp-featured countenance of acute peritonitis (facies hippocratica). yacial diagnosis without further examina- tion is not without its fallacies, but an experienced practitioner miy possess “ clinical instinct’ which, without a conscious log’cal process, at once tells him what is the matter, and is prodably due to recognition by the subconscious mind of a sim‘lar condition seen years before but forgotten. the use of vision in diagnosis has been greatly extended in recent years. the ophthalmoscope, invented by charles babbage (1792-1871) and modified by helmholtz, enables the retina at the back of the eye, which is an expansion of the brain, to be seen in all its details; similarly the laryngoscope, and more re- cently the bronchoscope, oesophagoscope, sigmoidoscope, endo- scope for lighting up and bringing before the observer’s eye the interior of the bronchial tubes, the gullet, the lower part of the bowel, and of the urinary bladder, have greatly facilitated the detection of disease in these situations. endoscopes have also been introduced into the chest (thoracoscopy) and into the abdo- men (laparoscopy or coelioscopy). skiagraphy.—skiagraphy or examination of the body by x-rays, discovered by prof. w. k. rentgen of wiirzburg in nov. 1893 (see anatomy; rontgen rays), has revolutionised diagnosis by rendering the greater part of the body translucent while the bony skeleton and certain abnormal formations remain opaque; x-rays provide a photograph or skiagram of great use in diagnosis; thus fractures can be shown, and similarly tumours, foreign bodies, certain morbid conditions, such as abscesses and collections of fluid, stones in the kidney and bismuth when in- troduced into the alimentary canal appear dark, while the sur- rounding parts are light. in this way malignant disease, ancu- rysins, tuberculosis and other diseases of the lungs and the condition of the alimentary canal can be recognised. further by introducing air into the abdomen the picture produced is ren- dered much clearer; recently the ingestion of dyes (tetraiodo- phenolphthalein or tetrabromphenolphthalein) which are ex- creted by the liver into the bile have been found to show up the gall bladder (cholecystography). use of instruments of precision —the well-established and obvious method of palpation or examination of the body by the hand has been greatly supplemented by the introduction of instruments of precision which record the movements of the heart, arteries and muscles; graphic records of the pulse by the polygraph, of blood pressure by the sphygmomanometer and of the heart by the electrocardiograph have added accuracy to the unaided but trained senses. the various forms of cardiac irreg- ularity have thus become clearly unravelled, and fresh in- formation about the condition of the heart muscle and its beats, such as the pulsus aliernuns and auricular fibrillation, has been secured. the electrocardiograph requires special technical skill (sce heart, diseases of the); but when once the existence of the underlying condition has been definitely established in diseases also accompanied by more obvious manifestations, the presence of the latter has now become sufficient to justify a diagnosis of the primary cause, and so to indicate its prognosis and appropriate treatment. this simplification of diagnosis by associated phenomena will, it is to be hoped, follow in many diseases in which the full explanation can originally be provided only by laboratory methods too elaborate or time-consuming for ordinary bedside practice. percussion of the chest, initiated by leopold auenbrugger in 1761, did not receive due attention until his book was translated into french by j. n. corvisart in 1808, when in conjunction with laennec’s method of auscultation (1819) it brought about a new epoch in the diagnosis of diseases of the lungs and heart. laboratory tests ——these methods of physical diagnosis are clinical and have been increasingly supplemented by tests adopt- ed from those carried out in laboratories. the distinction be- tween the clinical and laboratory methods of diagnosis is one eee are ee ai er diagnosis of degree, for some, such as the counting of blood corpuscles and the detection of various animal parasites, do not require the help of a specialised laboratory; hence clinical laboratories have now become an essential part of the equipment of a modern hospital or clinic. but other valuable tests are not possible in less favour- able circumstances. vhe chemical examination of the blood for its content of sugar and non-protein nitrogen has an invaluable bearing on diabetes and renal disease; the examination of the blood for antibodies has enabled the diagnosis of infectious dis- eases to be made when ordinary clinical methods fail, for ex- ample the wassermann reaction in the detection of syphilis, and the widal (also a complement-fixation) test in the diagnosis of enteric fever. bacteriological examination of discharges and ex- cretions, such as swabs from the throat in diphtheria, of the expectoration in pulmonary consumption, of the urine and of the blood, of the cerebrospinal fluid and of the faecal excreta, has enormously advanced the exact diagnosis of infectious diseases. thus to take an example, diseases which formerly were sometimes with difficulty distinguished by clinical examination (enteric fever, generalised tuberculosis, malaria and malignant endo- carditis) can now be identified readily by examination of the blood. chemical investigation of, and examination of the cells in, the blood, the fluids already mentioned and especially of the gastric juice by the method of fractional test meals have also rendered eminent service in the diagnosis of many diseases of the blood, nervous system, stomach and other organs. immunity tests —immunology (see immunity) or the science of the reactions given by persons who are immune or susceptible to certain infections or poisons has made it possible to say whether a person is liable to contract certain infections; thus by the widal complement-fixation test to determine whether or not an individual is protected against enteric fever, by the schick test against diphtheria and by the dick test against scarlet fever. in the two latter the diphtheria toxin or the scarlatinal haemolytic streptococcus toxin is injected between the layers of the skin; a local reaction shows that the individual is susceptible to the dis- ease, against which he can then be protected by injections into his muscles of the corresponding toxin. this may be regarded as protective diagnosis, and no doubt will become more general in its application. individual idiosyncrasies.—the exact cause of idiosyncrasies to certain foods, for example eggs, or to animal or vegetable sub- stances, such as hair, feathers and pollen, can be determined by rubbing on the abraded skin extracts of substances likely to be the exciting cause of one of the “ toxic idiopathies,” such as asth- ma or nettlerash. if an individual suspected to be hypersensitive to, say, the dandruff of horses, is thus tested with such an extract, the appearance at the point inoculated of a red area or wheal, much larger and more prominent than that produced ona control area of skin similarly treated, except that saline solution is ap- plied, strongly suggests that the disorder, such as asthma, is due to hypersensitiveness to this particular foreign protcin. general disease —general ill-health (dis-ease, want of ease), often of a vague character as shown by undue fatigue, but some- times severe and prominent, such as pernicious anaemia or malignant endocarditis, and also local affections, such as arthri- tis, are commonly due to some primary condition often in a distant part of the body, such as disease of the tonsils, in con- nection with the teeth, the gall bladder or the vermiform appen- dix; the symptoms are frequently, especially in the examples first mentioned, due to some local infection providing micro- organisms or their poisons only, which when carried to other parts of the body, e.g., the central nervous system, the blood- forming organs, the heart or the joints, set up changes and attract attention, while the foms ef ortgo remains latent. in such cases, and they are numerous, of secondary disease, search for the pri- mary infective focus is the scientific method of diagnosis, and may require expert advice from the laryngologist, dentist, the radi- ologist or other specialists. in other instances the primary cause sets up, through the nervous system, symptoms often in a com- paratively remote part, which are described as due to disordered reflex action; just as a decayed tooth may cause headache, a blow diaz, armando—diplomacy on the ulnar nerve at the elbow (the “ funny bone ’’) tingling and pain in the little finger, so may a stone in the kidney show itself by pain in the testicle on the same side, or a chronically inflamed appendix or gall bladder be responsible for dyspepsia. conclusions.—the foregoing examples show that with the ad- vance and necessary specialisation of medicine diagnosis may make demands which no one man can efficiently meet, and that in certain cases a satisfactory solution can be obtained only after examination and report by specialists. ife is a wise man who knows enough to recognise his limitations and to call for such assistance, whereas the converse course leads to the empirical treatment of symptoms, the continued discomfort and depend- ence, if nothing worse, of the patient and eventually perhaps to the doctor’s discredit. recognising this, hospitals have long carried out the combined diagnostic method, and more recently, especially in america, groups of doctors, each proficient in some branch of the healing art, have amalgamated to form “‘ diagnostic clinics” and to practise “ group medicine.” (hi. ro.) diaz, armando (1861— ), italian general, was born in naples dec. 6 1861. iie served in the italo-turkish war, and in 1914 was promoted to major-gencral. on italy’s entry into the world war he was chief of the operations department, and in 1916 became lieutenant-general in command of the 49th division. in nov. 1917, after caporetto, diaz became chief of the general staff, and under him the battle front was successfully reconsti- tuted and the austrian armies were destroyed by the battle of vittorio veneto (oct.—nov. 1918). in nov. rorg he was nomi- nated army general, and later became vice-president of the army council. in 1921 he was created duca della vittorio. on the advent of the fascist govt. he was appointed minister of war, and held that appointment until ill-health obliged him to resign in april 1924. on nov. 4 1924 the newly created rank of marshal was conferred on him. : diaz, porfirio (1834-1915), president of mexico (see 8.172), died in paris july 2 1915. dibelius, wilhelm (1876- ), german scholar, was born in berlin april 23 1876. he took up his residence as lecturer in berlin in r901, and in 1903 became professor at the academy of posen. he became professor of english at hamburg in rg11, and in 1918 went to bonn in the same capacity. in 1924 he was appointed professor of english language and literature at the university of berlin. he published join capgrave und die eng- lische schrifitsprache (1901); charles dickens (1916); england (2 vol., 3rd ed., 1924). dicey, edward (1832-1011), british jurist (see 8.178), died in london july 7 1911. his brother, albert venn dicey, died april 7 1922. dictograph: see officf appliances. dierx, leon (1838-1912), french poet (see 8.210), died in paris june 11 1912. his poesies posthumcs appeared in 1913. diesel, rudolf (1858-10913), german engineer, was born in paris march 18 1858. his principal achievement was the invention of the diesel oil engine (sce internal combustion engine; marine engineering), though he did not live to see its possibilities fully exploited. he fell overboard the antwerp- harwich mail steamer on the night of sept. 30 1913. dilke, str charles wentworth (1843-10911), british politician (see 8.271), died in london jan. 26 1911. he was succeeded as 3rd baronet by his son, charles wentworth dilke (1874-1918), who died in london dec. 7 1918, when the title passed to a cousin, fisher wentworth dilke (b. 1877). dillon, john (1851- ), irish politician (see 8.273), was prominent in 1902 in parliament in his attacks on the govern- ment for the revival of the crimes act, and in the following ycar he helped forward mr. wyndham’s land purchase act. with the return of a liberal government to power, mr. dillon, with mr. devlin of belfast, was associated with john redmond in the leadership of the nationalist party. in this capacity, like other irish members, he presented to parliament the grievances of evicted tenants and of the small farmers whose desire for land led them to indulge in ‘‘ cattle driving ” on the larger holdings devoted to grazing. for the preparation of the home rule bill 853 of 1912, he was almost as responsible as were ministers them- sclves. nor were his interests confined to ircland. he spoke frequently in the house on foreign questions; and while his altitude was critical of what he considered to be the imperialism of sir edward grey’s foreign policy, he was heard with respect and attention. in july 1914, he was invited by king george v. io accompany mr. redmond to the conference at buckingham palace which attempted to settle the irish controversy. when war broke out, he immediately placed his whole influence behind the british govt., speaking in this sense at the mecting in the dublin mansion house on sept. 25 1914. he took an active part, morcover, in recruiting and, with mr. redmond, consulted with the war ojfice as to the best way of adapting this cam- paign for volunteers to irish susceptibilitics. the progress of sinn fein in ireland steadily undermined the nation- alist position and john dillon suffered with the rest. he was convinced that the enforcement of conscription in ireland would merely aggravate the disaffection. he was completely sceptical of the press campaign in favour of a munitions depart- ment and belicved that the revolt against mr. asquith, as the prime minister responsible for conducting the war, was unfair and factious. he succeeded redmond as leader of the nationalist party which by that time was in extremis. in his desire to maintain the constitutional party against sinn fein, he denounced the measures of repression which followed the eastern rebellion of 1915, and brought forward a resolution suggesting that this coercion, as he regarded it, was inconsistent - with the principles on which the allies were fighting the war. at the gencral election of dec. 1918, he shared the general obliteration which overwhelmed the nationalist party. diphtheria: sce infectious fevers. diplomacy (sce 8.294).—the events of the ycars 1910-25 have created in the popular mind some misconception of the true nature of diplomatic practice. in particular, the controversy between the defenders of the “ old’ diplomacy and the sup- porters of the “‘ new ”’ has suggested an academic, and to some extent a false, distinction, or even conflict, between professional diplomacy and democratic control. a theory has gained wide acceptance that diplomacy possesses some detached or independent identity, parasitic and not organic to the living growth of the state. such conceptions are misleading: the history of diplomacy shows no such dramatic break in continuity; it shows merely a constantly fluid or organic process of adjustment, a constant endeavour to reconcile the maximum of representation with the maximum of efficiency. by “representation ” is meant the recurrent necessity of ad- justing the methods and the personnel of negotiation in such a manner as to render them fully representative of the ultimate sovereign authority of their national state; by ‘‘ efficiency ” is meant a constant endeavour to ensure that international inter- course is so conducted as to minimise the risks of misunderstand- ing, uncertainty or hasty action. it is the interaction of the impulse toward exact representation and the impulse toward increased efficiency which has since the 141h century constituted the main influence formative of diplomatic practice; the conflict between the “‘ old ” and the “‘ new ” diplomacy is thus no sudden development but merely this age-long process of adjustment presented in an increasingly intricate form. diplomacy may therefore be defined as representing those methods of international procedure which commend themselves io sensible men as being at any given period the most representa- tive and the most efficient for conducting negotiations between sovereign states. if viewed as the logical continuation of this unceasing process of adaptation and adjustment, the changes introduced during the period under review fall into a more reasonable perspective. ratification.—the most important of recent developments is the insistence of the legislature on a right to refuse ratification. in the united states this right is explicitly accorded to the senate by the constitution. in great britain, as in most euro- pean states, ratification is the prerogative of the sovereign, and treaties have not been submitted to the legislature unless money 854 clauses formed part of the instrument. it was generally assumed that the signature of a treaty by a fully accredited representative of a sovereign state implied as a merely formal corollary the rati- fication of that instrument, and it was only with the rejection by the united states senate of the treaty of versailles that this assumption was seriously challenged in europe. since then the conception has become firmly established that no important treaty, whatever the wording of its ratification clause, can be considered to have been concluded until it has been ratified by the legislatures of the leading signatory states. clearly this is a great gain in the direction of exact representa- tion, while the loss in efficiency may not ultimately prove so serious as might be supposed. it is unlikely on the one hand that any responsible modern govt. would in any case authorise the signature of a treaty unless they had good cause to count on the eventual approval of the legislature. on the other hand it must be admitted that this potential veto of the legislature introduces what, in some circumstances, might prove a dangerous element of uncertainty and delay; that it may seriously hamper the free and rapid exercise of judgment on the part of the executive; and that negotiations may thercby be unduly and protractedly ex- posed to the intluence of popular ignorance, clectoral excitement, party manoeuvres or press misrepresentation. open diplomacy.—it is not impossible that when once the legislature’s right of veto on an international commitment en- tered into by the executive is fully established and realised, the old agitation for “‘ open diplomacy ” will subside. the existence of this veto and the prohibition embodied in the covenant of the league of nations will in future render any secrct treaties but a precarious instrument in which to embody international agree- ments; nor is it unreasonable to hope that when once modern democracies fee! safe-guarded against the obligations of such secret treaties, they will recognise that the battle has been won, and that it is unnecessary and highly inconvenient to insist that open covenants should also be openly arrived at. the admirable balance between representation and efficiency, between publicity and discretion, achieved at the conference of locarno in oct. 1925, 1s likely to serve as a model of how to adjust the require- ments of modern democracies to the smooth working of inter- national negotiation. the deemmocratic control of diplomacy apart from the very effective control which can be exercised by the legislature through its veto on treaties which have been already signed by the executive, there exists in many countries a strong body of opinion which demands some more continuous form of parliamentary supervision over the foreign policy of the govt. and its servants. in great britain this movement has concentrated on the demand for a foreign affairs committee of the house of commons endowed with the same privileges and prestige as the foreign relations committee of the senate in the united states, or the analogous parliamentary committees in france and germany. the advantages of such committees are that they enable the foreign secretary accurately to gauge parliamentary opinion, while they provide parliament with a saicty-valve for criticism or suggestion which might be unsuitable for public debate. the disadvantages are that they entail extra labour on the foreign secretary, that they often seem to emphasise difficulties and disagreements which might otherwise be solved automatically, that they introduce into the conduct of foreign affairs a party and sometimes a personal ele- ment, that they constitute a channel through which financial and commercial interests may endeavour unduly to influence policy, and that they lead invariably to indiscretions and disclosures. diplomacy and the press.—one of the most delicate problems of modern diplomacy is that of publicity. full publicity is inimical to negotiation, partial publicity is apt to cause mis- understanding. when editors and correspondents have some sense of responsibility the problem is comparatively simple: they can be told the whole story and informed exactly why certain portions thereof are unfitted for publication. unfortu- nately in moments of international excitement the discretion and ~ diplomacy integrity of every journal cannot always be relied on; nor can all negotiators resist the dangerous temptation of utilising their own press in order to reinforce their arguments by the excitation of their national opinion. the dangers of misdirected publicity are especially apparent during international conferences, and the greatest difficulty is experienced in maintaining a united front of discretion as between the several delegations. the more recent tendency is to throw on the press itself the responsibility of using with good sense and discretion the material with which it is pro- vided: but in the case of sensational or violently prejudiced journals, the temptation to abuse this gesture of confidence is obviously very great. diplomacy and commerce—great progress has been made during the last few years in bringing the diplomatic services into close contact with the commercial needs of the peoples whom they serve. so long as this tendency develops on the lines of justifiable support for reputable commercial enterprises, and of the provision of full trade statistics and information, nothing but good will result. the institution by the british govt. of the dept. of overseas trade, and the analogous creation by the u.s. govt. of the bureau of foreign and domestic commerce, both with their representatives in foreign trading centres, are important steps in the right direction. on the other hand, a tendency has arisen in certain states to expect from thcir repre- sentatives abroad a greater measure of commercial activity and intervention than is wholly consonant, either with their own prestige and political interests, or with the maintenance of har- monious relations with other competing countries. this ten- dency, 1f pursued, cannot contribute to the amity of nations. democratisation of the diplomatic services—an interesting commentary on the constant iteration upon diplomatic practice of the concurrent needs of representation and efiiciency is fur- nished by the reforms which have since r919 been introduced into the foreign services of the united states and the british empire. in great britain the foreign service was found to be too pro- fessional and not sufficiently representative; in the united states of america the forcign service was found to be too representative and not sufficiently professional. in great britain the royal commissions of 1861, 1871, 1886 and ro14 successively made recommendations tending to give to the british diplomatic service 4 more representative and less exclusive character. the regulations adopted as a result of the r9or4 recommendations are of particular importance in that admission to the british foreign service was thereby to all intents and purposes thrown open to public competition, the examination being assimilated to that of other branches of the civil service. the old property qualifica- tion, which had in practice restricted recruitment to the richer classes, was abolished, the salaries and foreign allowances were graduated with the object of enabling a diplomatist to be inde- pendent of private means, and the board of selection, which had been instituted in 1997 to select candidates for examination, was reconstituted on a more representative and democratic basis. in the united states, on the other hand, the tendency as shown by the reorganisation act of may 24 1924 has been to abandon the extreme representative or “ spoils” system (under which the whole personnel of the foreign service were adherents of the political party in power), and to create in it8 place a professional or standing foreign service. diplomacy and the british dominions -—the international status acquired since 1914 by the british self-governing domin- ions has faced the british empire with a new and highly com- plicated aspect of the old problem of reconciling representation with efliciency. this new issue, although it is engaging anxious thought, has as yet been dealt with primarily by the expedient of keeping the dominion govts. fully informed of any important diplomatic developments. some machinery for rapid con- sultation, probably in the form of increased liaison, will doubtless be devised in the near future. for the moment it can only be said that the present system is unsatisfactory, and that it can only be regarded as provisional. (see britisn empire.) in so far as the changes noted above render diplomatic practice more exactly representative of modern conditions, they clearly director firing—disarmament contribute to the greater efficiency of international intercourse. nothing leads more surely to confusion and uncertainty than any failure on the part of the negotiator to identify himself with the ultimate sovereign authority in his own country. on the other hand, successful diplomatic negotiation necessitates a certain detachment from herd-emotion, and it has always, and will always, be found that diplomacy works most efficiently when conducted on the lines which the experience of generations has evolved as being the most convenient. it is for this reason that so few permanent changes have been introduced during the period under review into the actual formalities of diplomacy. the perpetual servitudes and moral judgments introduced into the treaty of versailles will not form a precedent; the spasmodic revival of the old practice of direct personal cor- respondence between foreign ministers 1s a too dangerous method to become habitual; the attempt to render diplomacy bilingual will be maintained only with difficulty; the war habit of propaganda may well prove too invidious and expensive for con- tinuance; the increased facilities of communication may well modify, but will certainly not diminish, the value of personality in diplomatic representatives abroad; the wholesale appointment to embassies and legations of men outside the profession is not, as the u.s. govt. has found, a practice which contributes to general efficiency. equally transitory may well prove the system of ‘‘ diplomacy by conference,” which has since r915 become so frequent a feature of international intercourse. such ad hee con- ferences were essential during the war, and in the period of post-war liquidation. but when once the concert of europe is re-established, it will probably be found that these dramatic meetings will be abandoned and that personal contact between the various foreign ministers (a system which, if not exag- gerated, is highly useful) will be maintained at the periodical meetings of the council and the assembly of the league of nations. it is too early as vet to estimate the effect upon diplomatic practice of the institution of the league of nations (q.v.). until 1925 that body, however admirable its ideals and intentions, was in essence representative only of the will of the allied coalition. with the entry of germany it will approximate to the old con- cert of europe with these important differences, namely, that it will possess a trained international secretariat, and that it will hold periodical meetings. diplomacy, therefore, which, what- ever its critics may contend, is the art of preserving international peace, may well find in the league of nations a highly eflicient instrument for the attainment of its objectives. bibliography.—sir ernest m. satow, a guide to diplomatic practice (2 vol.). this will doubtless become the classical authority on the subject: a new edition (1922) deals, though not in great detail, with development since i914. edward $. corwin, the president's control of foretgn relations (1917), a uscful summary of this controversy. arthur a. w. h. ponsonby, democracy and the control of foreign affairs (1912); t. ii. lay, the foreign service of the united siates (1925). this admirable summary contains a wise and illuminating preface by hon. charles e. hughes. george young, diplomacy old and new (1921), a controversial publication. j. a.a. j. jusserand, the school for a mbassadors(1924). the first essay in this book is very useful. see also the excellent publications of the british institute of international affairs upon the paris peace con- ference and subsequent setticments. (h. n1.) director firing: sce gunnery. disarmament.—the word disarmament is used to cover two distinct conceptions: first, the complete abolition of all military armament, desired by a certain school of advanced thinkers; second, the reduction and limitation of national arma- ments by a general international agreement accepted by all, or almost all, states. in the former sense of the word, disarma- ment cannot yet be said to be practical politics. in the second sense it is one of the great problems of the day. partial disarmament by treaty.—some attempts to achieve a concrete reduction and hmitation of armaments were made before the world war of 1914-9. in isolated instances, where agreements were made between countries geographically remote from the rest of the world, a measure of success was obtained. thus some south american republics reduced their armaments 855 in accordance with arrangements made by treaty, while in a number of cases two countries agreed to the demilitarisation and sometimes to the actual neutralisation of the zone surrounding the frontier between them. the most striking example of dis- armament by friendly agreement is that of the 3,000 m. land frontier between canada and the united states, which has been demilitarised since 1818. another is the frontier between norway and sweden, which was neutralised when the two countries separated in r905. early in 1870 britain proposed such disarmament to france and germany, but germany refused to discuss the matter. but whenever any attempt was made to reach a general agree- ment on disarmament, as for example, at the hague conferences of 1899 and 1907, failure was immediate and complete. owing to the attitude of germany all definite plans were prevented; during the 20 years preceding 1914 all the more powerful governments spent an ever-increasing proportion of their national wealth and resources in building up greater and greater fleets and armies. it was widely believed that as soon as the world war was over, and the german menace was removed, disarmament would be brought about almost by itself; but in fact the burden of arma- ments remained almost as oppressive as before. nevertheless, although great armaments were still maintained after the war, disarmament in the second sense did become a matter of practi- cal politics. disarmament under the peace treaties of t919.—in the first place, the principle of disarmament was effectively applied to the states defeated in the war. under the treaties of peace, germany, austria, hungary and bulgaria accepted an immense reduction and a rigid limitation of the armed forces which they respectively maintained. ‘the treaty clauses relating to these armed forces were worked out in the greatest possible detail and laid down the number of men, the equipment, the transport and the armament which each of the four states was allowed to maintain, germany’s army being fixed at a total of 100,000 men. moreover, conscription was abolished and both armies and navies were to be recruited on the basis of long-period voluntary service. the manufacture of arms in the ex-enemy countries was forbidden, and a rigid control by the victorious allied powers was established to see that the disarmament provisions were carried out. it was hoped that in this way the ex-enemy states would be bound down to a fixed scale of armament, and that they could be prevented from building up great secret reserves, cither of man-power or material. although it was one-sided, this disarmament of the ex-enemy powers was nevertheless a considerable factor in the general post-war situation and in itself did much to make general dis- armament practically important. for, apart from its obvious political effect, it was expressly recognised in the peace treaties that the disarmament of the ex-enemy powers was only prelimi- nary to a general reduction and limitation of armaments by the world at large. the preamble to part v. of the treaty of versailles, for example, says:— in order to render possible the initiation of a general limitation of the armaments of all nations, germany undertakes strictly to observe the military, naval and air clauses which follow. provisions of the covenant.—secondly, specific obligations with regard to disarmament were imposed upon all the members of the league of nations by article 8 of the covenant. in this article, recognised by the authors of the covenant to be funda- mental to the successful working of the league, the members recognise that the maintainance of peace requires the reduction of national armaments to the lowest point consistent with national safety and the enforcement by common action of international obligations. the article goes on to provide that the council of the league shall formulate plans for such reduction for the consideration and action of the several governments, . . . after these plans shall have been adopted by the several governments the limits of armaments et shall not be exceeded without the concurrence of the ouncil. 856 to this must also be added the final act of the conference of locarno, in which new undertakings to carry out article 8 were made by the great powers there assembled. third, these are not merely paper obligations. since the end of the war it has been recognised more and more widely that article 8 muse be carried out if the league of nations is to fulfil the purposes for which it was created. british statesmen have made the strongest possible declarations on the subject. lord grey, lord cecil, mr. macdonald, mr. baldwin, mr. austen chamberlain, among others have declared that both in the interests of the british empire and of the world at large it is necessary to secure a general and mutual reduction of armaments without delay. lord grey summed up their arguments in a single sentence by saying that “if civilisation cannot destroy armaments, armaments will destroy civilisation.’ he claimed to be expressing an almost universal conviction that armaments are not only a result, but also a cause of policy; that they not only arise from a sense of insecurity but that they increase that sense of insecurity and thus cause war among nations. article 8 of the covenant is an undertaking by the members of the league to co-operate in preparing a plan of disarmament and in making the treaty required to bring that plan into effect. in the fulfilment of this task the principal rele is assigned to the council, which has first to prepare a plan for the “ consideration and action of the several governments,” and which is sub- sequently to control its observance. the temporary mixcd commission.—it was not the council, however, but the assembly of the league which took the first important step towards executing article 8. at the first assembly in 1920 a resolution was adopted calling for the creation (by the council) of a special committee of experts of various kinds to study disarmaments and to draft a scheme. on this committee, the “ temporary mixed commission, ” there were appointed military, naval, air, economic and financial experts, and to them were added also some persons of political experience. it first met in 1921 and early in its discussions lord esher produced a scheme, restricted to the limitation of the land-armaments of europe. lord esher’s plan, to which perhaps no very great consideration had been given, was founded on the principle that equal proportionate reduction of the arma- ments maintained by different countries in time of peace would affect the different countries equally and, therefore, while affording them all relief from a considerable burden, would not alter their relative military strength. this, of course, is the classical argument for a general reduction of military forces; but, although at first sight it seems an obvious proposition, it was not agreed to by all the members of the temporary mixed commission. on the contrary, the european members of the commission almost unanimously rejected it. they contended that, while it may once have been true that proportionately equal reductions of military armaments and forces by international agreement would leave countries relatively as strong as they were before, in modern conditions this would no longer necessarily be so. they maintained that the application of science to war had introduced such changes in methods and weapons that no disarmament agreement could now include and limit all the vital factors on which military strength depends, since many of these vital factors are important elements in the normal peace-lime eco- nomic life of the nations of the world. after prolonged and difficult discussion of these arguments, it was recognised by the temporary mixed commission that reduction of armaments could not come alone but that it must be accompanied by arrangements, supplementary to those of the covenant, for ensuring the security of members of the league against aggressive attack. this conclusion was summarised in four resolutions adopted by the temporary mixed commission and subsequently by the third assembly in 1922, the gist of which was that disarmament to be effective must be general, and that “ secu- rity ’’ and disarmament must go together. security negotiattons.—on the foundation of these four im- portant resolutions the temporary mixed commission pro- disarmament ceeded in the following year to draw up the draft treaty of mutual assistance. the purpose of this draft treaty was to provide a system of general security which would permit the calling of a disarmament conference. disarmament was inti- mately linked to the general scheme by the provision that none of its undertakings of mutual guarantee would come into effect untila plan of disarmament had been actually adopted and carried out. the treaty of mutual assistance was not, in fact, adopted by the succeeding assembly, but the fifth assembly in 1924 elabo- rated the geneva protocol, which was founded on the same principles, and in which again the coming into force of a security system was made conditional upon the previous adoption at a disarmament conference of a general plan for mutual reduction and limitation of national armaments by the important countries of the world (see security). the geneva protocol, in its turn, failed to secure sufficient acceptance by leading governments to bring it into force, and instead, the method of regional pacts was attempted by the british foreign secretary, mr. chamberlain. once again, when his negotiations ended in the conclusion of the locarno agree- ments, the final act of the conference contained a new pledge that the security pacts should be followed by the adoption of a gencral plan of reduction and limitation. thus the whole course of the discussions and negotiations on the subject between 1919 and 1926 proved conclusively the essential connection between security and disarmament. on the problem of security those years witnessed much progress. in other respects, however, less progress was made. quite apart from the problem of security, disarmament itself in its technical and technical-political aspects is anextremely intricate matter. it can hardly be expected that other governments will freely accept the simple but drastic system imposed on germany and her allies, desirable though it might be that they should do so. technical difficultics —but the technical difficulties of a more clastic system are very great. how is the total strength of one country to be compared with that of another, or the power of one weapon to be measured against the power of another? how are weapons to be limited at all? how can secret preparation and storing of arms be stopped? ilow can the ratio of strength between different powers be settled? what arrangement can be made for the simultaneous carrying out of disarmament provisions when they have been accepted? these are formidable questions and the complicated technical problems which they raise were hardly touched on in the earlier discussions on the subject. the success of the washington naval conference (sce wasiiington conference) does not give any indication of the lincs on which they could be solved, for not only is naval disarmament infinitely simpler than military and air disarmament, but even among naval units the washing- ton treaties dealt with only two categories of fighting ships. at length, however, the sixth assembly of the league recognised the importance of this side of the matter and decided that its study should be begun in order that, when security had been obtained, the work of the disarmament conference might be rapidly carried through. it remains to be seen what success will attend the league commission, on which it should be noted, the united states has a seat. in conclusion, it may be said that the negotiations on disarma- ment which have so far taken place have been based on the following accepted principles:— 1. that general security is a necessary condition of general disarmament; 2. that the organisation of a system of sanctions through league of nations machinery is the only road fo security; 3. that.to this end the “ gap” in the covenant, by which re- course to aggressive war is in certain cases legitimate, must be abolished, and aggressive war in all cases made an international cerinic; 4. that no scheme of disarmament can succeed unless it is accepted by all or almost all governments and unless it covers every kind of weapon and military preparation; 5. that only through the permanent machinery of the league can the necessary preliminary preparation for a disarmament conference be carried out; and 6. that no plan for general disarmament will give confidence to distribution of animals governments and peoples unless it is supported by an impertal international system of control and supervision, which again can only be organised through the machinery of the league. bibliography.—- league of nations publications: reports of the temporary mixed commission on armaments: sept. 15 1921, a. 81, 1o21*-sept,: 7, 122;, ae 3h, 1022) aue. - 15: 1023,..4. 25; 1023. lns: july 30 1924, a. 16, 1924, in.; report of the third committee to the fourth ‘assembly, a. v11., 1923; debate in the fifth assentbly. record of speeches by english and french prime afinisters, etc., sept. 4-6 (1924); .lrbitration, security and reduction of armaments. docu- ments and proceedings of the fifth assembly, oct. 1924. see also: p. j. noel baker, disarmament (1926). hota (an 6