276 PHLORIDZIN DIABETES 



amounts of sugar accumulate in the blood, here one cannot 

 find evidence of any sugar stagnation. The explanation of 

 this peculiarity is simply that the kidney is concerned here, 

 not merely with the excretion of the sugar that is brought 

 to it, but that in phloridzin diabetes the latter is, at least in 

 large part, produced in the kidney itself. Here, therefore, 

 we are dealing with a " renal diabetes." 



Role of the Kidney. There can be no doubt as to the 

 essential part played by the kidneys in phloridzin diabetes. 

 This was impressed long ago by the experiment of N. Zuntz, 

 who noted when he injected the glucoside into one of the 

 renal arteries that the corresponding kidney eliminated 

 sugar earlier and more freely than its fellow. 3 In the same 

 line are to be classed the perfusion experiments upon ex- 

 cised living kidneys conducted by Biedl and Kolisch 4 and 

 by Pavy 5 and his collaborators. Exactly what is the renal 

 activity in phloridzin diabetes? Wohlgemuth believes we 

 are justified in concluding there is an increase of diastases 

 in the kidneys, produced from the influence of the phloridzin, 

 leading to an increased enzymic activity of the renal cells. 6 

 Otto Lowi 7 was able to show, contrary to opposite opinions, 8 

 that sugar elimination by a phloridzin kidney is not in- 

 creased by setting up in addition a salt diuresis. There is, 

 therefore, an increased activity of a special kind seen in 

 the effect of phloridzin. 



Many writers were disposed to interpret phloridzin dia- 

 betes on the assumption that normally the blood sugar is 

 retained by the kidneys because it is not in a free state but 

 in colloid combination ; that in phloridzin diabetes this com- 



8 N. Zuntz, Verb. d. Berlin. Physiol. Ges., Arch. f. Anat. u. Physiol., 1895, 

 570. 



4 A. Biedl and Kolisch, Verb. d. 18. Kongr. f . innere Med., p. 573, 1900. 



F. W. Pavy, T. G. Brodie and R. L. Siau (London), Jour, of Physiol., 29, 

 467, 1903. 



6 J. Wohlgemuth, and J. Benzur, Biochem. Zeitschr., 21, 460, 1909. 



T 0tto Lowi and E. Neuhauer (Pharm. Instit., Vienna), Arch. f. exper. 

 Pathol., 59, 57, 1908. 



8 S. Weber (Minkowski's Clinic) , Arch. f. exper. Pathol., 54, 1, 1905. 



