OXIDATION IN DIABETES 257 



circulation. As shown by several investigators, 27 a normal 

 heart in beating is able to take up and consume a not incon- 

 siderable amount of sugar from the circulating fluid. 

 Starling found that the sugar consumption by the heart of 

 a pancreatic-diabetic dog (transmitting its own blood) is 

 minimal or practically nil. If, however, a heart from an 

 animal with pancreatic diabetes was supplied with normal 

 blood, it was able to consume sugar. Moreover when a 

 small amount of pancreatic extract was added to the diabetic 

 blood there always followed a marked rise in the sugar con- 

 sumption in the diabetic heart. Starling states that 

 " meanwhile the conclusion seems justified that normally a 

 hormone is produced by the pancreas, the presence of which 

 in the blood is essential to the assimilation and utilization 

 of the blood sugar. Our experiments are proof that pan- 

 creatic diabetes is more likely to be caused by a diminished 

 capacity of the tissue to make use of the sugar than by a 

 primary exaggeration of its production. ' ' 28 



The next question which presents itself is whether we 

 are in position to frame some reasonable theory as to the 

 kind of disturbance of function which interferes with the 

 tissues consuming the sugar in a normal manner. 



Oxidation Processes in the Diabetic Economy. That we 

 are not dealing here with a diminution of the oxidizing 

 power of the tissues in general has been long known. On the 

 contrary, recent investigations upon animals with pancreatic 

 diabetes show that an increased consumption of oxygen may 

 be regarded as a characteristic symptom in severe diabe- 

 tes. 29 It has also been shown that the first products of sugar 

 oxidation, gluconic acid, glycuronic acid and saccharic acid, 



87 Chauveau and Kaufmann, Locke and Rosenheim, and Rohde. 



28 In reference to the hypotheses (Chauveau, He"don, Kaufmann and others) 

 which attempt to refer pancreatic diabetes to an increased sugar production 

 dependent upon the effectiveness of the liver and of the central nervous system, 

 see A. Biedl, 1. c., pp. 391-392. 



2> C. v. Voit, Leo, Weintraud, Falta, Grote and Stahelin, Mohr ; for Literek 

 ture consult R. Umber, Lehrb. d. Ernahr., p. 138, 1909. 



17 



