322 LECTURE XIV. 



again more than 2.8. There is apparently no reason why we should 

 say that either the fats or albumins do not produce sugar; and when we 

 find one author regards fats, and another albumin, as the sole producer 

 of sugar other than carbohydrates, it only means that there is no direct 

 proof of a formation of sugar from either one of these substances, but 

 there is merely an indirect proof of their influence. Too much depends 

 upon the interpretation of the results. Whether sugar is formed normally 

 from fat or albumin has not been proved by any of the experiments. It 

 is possible that the organism of the diabetic and that of the dog suffering 

 from glucosuria, may behave in entirely different ways. 



We must consider the possibility that the glucosuria produced by 

 different causes may have different effects. We do not know the organs 

 in which the transformation of albumin or fat into sugar takes place. 

 This does not preclude the possibility that the process is carried on for 

 both substances in the same place, nor that the transformation of one 

 material is more affected than another in any given case of glucosuria. 

 An observation of G. Rosenfeld 1 may have a bearing on this subject. He 

 caused a dog weighing between 3 and 5 kilograms to fast for five days, 

 and then on the sixth and seventh days injected 2 or 3 grams of phloridzin. 

 Carbohydrates were fed to the dog at the same time. The dog was killed 

 on the eighth day. The liver showed no indication of fat infiltration. If, 

 on the other hand, there is no carbohydrate in the food, but fat, or nothing 

 at all, is fed, a decidedly fatty liver is obtained. While the amount of fat 

 in the liver of a fasting dog is about 10 per cent of the dry substance, the 

 livers of animals used for the last experiment have shown from 25 to 75 

 per cent of fat. The glycogen had shrunk to small proportions. The 

 fatty liver disappeared two days after the injection of the phloridzin. 

 In these cases, as was shown by microscopic examination, the fat 

 was not deposited in the connective tissues, but directly in the liver 

 cells. Here it is a transference of fat from other organs of the body, as 

 was shown by Rosenfeld, and not a transformation of glucose or albumin 

 into fat. 



It is possible that this phenomenon has some connection with the con- 

 version of fat into sugar, although it need not apply to glucosuria due to 

 other causes. No fatty liver results, for example, in glucosuria caused by 

 extirpation of the pancreas. It, therefore, appears, a priori, wrong, to place 

 the various forms of glucosuria and diabetes upon the same basis, simply 

 from the fact that they have in common the predominating symptom of 

 glucohemia and the resulting glucosuria. The widely different causes of 

 the different kinds of glucohemia cannot be sufficiently emphasized. It is 

 possible that a study of an individual case in different directions, rather 



G. Rosenfeld: Verb. Kong, innere Med. 359 (1893). 



