266 HUMAN DIABETES 



more or less seriously disturbed. 59 Kemembering the 

 rapidity of postmortem disappearance of glycogen and the 

 fact that the small amount of intake of nutrition before 

 death may also influence the amount of glycogen in the liver, 

 it is naturally somewhat difficult, to say the least, to come 

 to any precise conclusions in a human diabetic as to his 

 glycogen stock. The noted clinician, Frerichs, satisfied his 

 curiosity in this respect (by a very direct method, but one 

 scarcely to be commended for general use) by removing 

 during life bits of liver tissue by puncture in two cases of 

 diabetes ; one of the specimens contained glycogen. When 

 we recall that diabetic patients are able to change laevulose 

 into glycogen more readily than they can transform glucose, 

 it is very suggestive that, as a study in the Vienna Phar- 

 macological Institute 60 indicates, a rabbit's liver damaged 

 by phosphorus poisoning makes a like differentiation be- 

 tween dextrose and Isevulose ; this particular power of dif- 

 ferentiation is, therefore, by no means a characteristic of 

 diabetes exclusively. 



It has been previously stated that quantitative examina- 

 tion of the diabetic liver for its diastase has not led to 

 definite conclusions. 



Hyperglyccemia. Hyperglycaemia in diabetic cases is gen- 

 erally accepted. While the amount of sugar in the blood 

 of a normal human individual amounts to about 0.1 per cent., 

 the proportions in the diabetic have been noted as high as 

 one per cent, or even more. This in itself is sufficient reason 

 for the presence of a considerable amount of sugar in the 

 cerebrospinal fluid (obtained by lumbar puncture) ; notably, 

 the highest figures (as high as three per cent.) having been 

 met in comatose cases the urine of which contained only 

 moderate amounts. 61 



Methylene-Blue Reaction of the Blood. This character- 



M Cf. Literature: A. Magnus-Levy, 1. c., pp. 357-358. 



60 E. Neubauer (Pharmacol. Instit., Vienna), Arch. f. exper. Pathol., 61, 

 174, 1909. 



61 N. B. Foster, Boston Med. and Surg. Jour., 153, 441, 1905. 



