DR. PAVY AND DIABETES 23 



is of the order of from 5 to 6 grammes, so that if the 

 daily flow of lymph from the intestine really brought so large 

 a mass of lymphocytes into the blood, either the rate at which 

 they are destroyed must be almost inconceivably rapid or else 

 a meal would increase their numbers to a degree out of all 

 proportion to that observed. 1 



Pavy himself made an important discovery, which he felt 

 made it easy to believe in the temporary disappearance of the 

 carbohydrate of the day's diet in the bioplasm of lymphocytes. 

 Such a cell consists normally in the main of protein ; Pavy, 

 however, found that a carbohydrate constituent is always con- 

 tained in the molecules of proteins. We are to see that this 

 is a fact with qualifications ; but neglecting these for a moment, 

 it must be remembered that the protein in the diet, which 

 has to be assimilated, already contains its own proper pro- 

 portion of carbohydrate and a proper proportion of carbon 

 and nitrogen. To this, if we read our author literally, the 

 growing bioplasm of the intestinal leucocyte adds all the 

 carbohydrate of a mixed dietary, so that its composition 

 as it enters the blood-stream must be very different from 

 anything met with in a normal animal cell : the proteins of 

 the lymphocyte must contain some three or four per cent, of 

 nitrogen only, instead of fifteen or sixteen per cent. Otherwise 

 it must proceed from the intestine loaded with glycogen, a 

 condition which Pavy does not predicate and which histological 

 examination disproves. 



I have assumed in the last few paragraphs, because Pavy 

 appears to assume it, that the lymphocyte could assimilate 

 all the material from the intestine and arrive in the blood 

 with the supply intact. This could not be the case actually ; 

 considerations respecting energy make it impossible. The 

 growth of living cells can never go on in such a way that 

 the total energy of the material consumed during growth is 

 stored in the material built up. Such rapid growth and 

 destruction of cells as the hypothesis under discussion calls 

 for is of such an exceptional kind that we have no data upon 

 which to base an estimation of the energy changes likely to 

 be involved ; but it is certain, I think, that the process would 

 involve a liberation of energy during the period in which food 

 is absorbed out of all proportion to that actually observed. 



1 Cf. Halliburton, Lancet^ 1909, Jan. 2. 



