258 PANCREATIC DIABETES 



undergo combustion readily also in the diabetic organism 30 



GLUCOSE GLUCONIC ACID GLYCURONIC ACID SACCHABIC ACID 



CH,.OH CH,.OH COH COOH 

 (CH.OH) 4 (CH.OH) 4 (CH.OH) 4 (CH.OH) 4 

 COH COOH COOH COOH 



(as, too, it finds no difficulty in oxidizing a substance as 

 close to dextrose as glucosamine, CH 2 .OH- (CH.OH) 3 - 

 CH.ME 2 - COH). 31 It might possibly be thought that the 

 diabetic has merely lost the ability to manage the first step 

 in sugar combustion (the oxidation of glucose into gluconic 

 acid). If that were the case, however, it would be difficult 

 to interpret the fact that diabetics react to the introduction 

 of chloral, camphor, etc., just as the normal individual does, 

 by the excretion of combined glycuronic acids. 32 This shows 

 clearly that the diabetic has the power to carry sugar 

 oxidation as far as glycuronic acid. One might draw the 

 conclusion from this that normal, physiological combustion 

 of sugar does not follow the path through gluconic acid and 

 glycuronic acid, that glycuronic acid is only produced excep- 

 tionally, if occasion demands detoxification of some foreign 

 substance or other. It might be conceived, too, that in diabetes 

 the economy still retains the ability to oxidize the sugar into 

 glycuronic acid, but loses its ability to effect the normal, 

 physiological catabolism of the sugar (presumably disin- 

 tegration of its molecule into compounds with two or three 

 carbon atoms, like lactic acid). 



Metabolism in Pancreatic Diabetes. As for the other 

 metabolic features of pancreatic diabetes, the affection is 

 characterized by a decided increase of protein and fat de- 

 struction and by an increased elimination of the mineral 



80 0. Baumgarten (Med. Clinic Halle), Zeitschr. f. exper. Pathol., 2, 53, 

 1905. 



81 J. Forschbach (Minkowski's Med. Clinic, Cologne), Hofmeister's Beitr., 

 8, 313, 1906. 



82 See H. G. Wells, Chemical Pathology, p. 530, 1907; O. Baumgarten, 

 Zeitschr. f. exper. Pathol., 8, 206, 1910. 



