4 1 4 Relation of Salts to Carbohydrate Metabolism 



cantly by injection of a lo per cent solution of NaCl. This change was 

 attributed entirely to blood dilution, resulting from the hypertonic infusion. 

 In an attempt to determine the influence of various electrolytes on the action 

 of insulin, Abelin and Goldener* at about the same time found that 2 gm. 

 of NaH^PO^ or 2 gm. of a mixture of NaCl, NaHCOg and Na^SO^ given by 

 mouth to a rabbit produced marked augmentation of the hypoglycemic effect 

 of 4 to 6 units of insulin injected simultaneously. Semler" reported finding no 

 change in the blood sugar of two diabetic men following the injection of 5 

 gm. of NaCl without insulin. Because of the finding of low blood chloride 

 in diabetics and high blood sugar in various conditions accompanied by 

 hypochloremia, such as intestinal obstruction or histamine poisoning. Glass 

 and Beiless"" reinvestigated the effects of injecting hypertonic NaCl solutions 

 in diabetic subjects. In ten such patients they found that a single injection of 

 3 or 4 gm. of chemically pure NaCl in a 15 to 20 per cent solution caused a 

 decrease in blood sugar of from 12 to 43 per cent with great regularity. A 12- 

 gram dose of NaCl given by mouth had a similar effect. In explanation of 

 their results, these authors claimed to have excluded the possibility of blood 

 dilution or of spontaneous fluctuation in blood-sugar concentration. They 

 attributed the blood-sugar-lowering effect to the CI ion rather than to the 

 Na ion and suggested that the salt exerted a vagotonic action. 



Relationship of Potassium to Carbohydrate Metabolism 



No reference is made to a possible relationship between K and carbohydrate 

 metabolism in any of the foregoing papers, in spite of the fact that the possi- 

 bility of such a relationship was first suggested shortly after insulin was dis- 

 covered. Briggs and co-workers" found an average decrease of 24 per cent in 

 the serum K of fasting dogs following the injection of insulin in large doses. 

 Shortly thereafter Harrop and Benedict" independently observed in both 

 normal and diabetic subjects that a fall in K accompanied the well-known 

 decreases in blood glucose and inorganic phosphorus, which result from 

 administration of insulin. They suggested that K may enter into the inter- 

 mediary metabolism of carbohydrate in association with the phosphorus- 

 carbohydrate combination. Many other investigators (Wigglesworth and 

 co-workers;'^ Hausler and Heesch;" Kerr;" Cori and Cori;'* Ellsworth and 

 Weinstein;" Keys;'* McQuarrie and co-workers'^) have likewise found insulin 

 hypoglycemia to be accompanied by a simultaneous fall of plasma K and PO^. 

 Data obtained subsequently from many other sources have strengthened 

 the hypothesis that K participates in some essential manner in the synthesis 

 and breakdown of complex polysaccharides both in plant life and in the 

 animal body. Plant cells behave in a general way like the liver cells in animals 

 as regards the movements of K and sugar. Pulver and Verzar^ showed that 

 K and sugar absorption and output are paralleled in yeast metabolism. Day 

 and Comboni^' studied the role of K in starch synthesis by plants (Pisum 

 sativum) giown from seeds in sand cultures with complete nutrient solution 



