FORMATION OF SUGAR IN THE KIDNEY 277 



bination is broken in the kidneys and these organs are then 

 enabled to filter the sugar out of the blood. Under the in- 

 fluence of phloridzin very considerable quantities of sugar 

 may appear in the urine, to be invariably made good at 

 expense of the proteins after consumption of the carbohy- 

 drate supply of the body. Possibly this may be explained 

 by the idea that (very much as a Toricellian vacuum has a 

 tendency to attract gases) the body does not permit the 

 existence of a " sugar vacuum " in the blood but endeavors 

 to repair the void with all the substances at its command. 

 But in criticism of this attempt to explain the nature of 

 phloridzin diabetes it must be recalled that, as has been 

 previously discussed, we have no certain ground for predi- 

 cating the existence of such a colloidal combination of the 

 sugar in the blood. 



There is no reason for supposing this form of diabetes 

 to be in any way related with the glycogen function of the 

 liver. Frank and Isaak 9 were able to show that dogs in 

 state of starvation continue to eliminate large amounts of 

 sugar when phloridzin is administered even after inhibition 

 of the hepatic function (that is, after severe changes have 

 been produced) by phosphorus poisoning. 



Formation of Sugar in the Kidney. These last authors 

 have, in the writer's opinion, made a suggestion worth con- 

 sidering, that the kidney under the influence of phloridzin 

 is not only able to separate sugar from the blood, but be- 

 comes capable of inducing synthesis of sugar and acquires 

 the property of building up sugar from non-carbohydrate 

 primary material. The observation that in animals with 

 phloridzin diabetes there usually is to be found an increased 

 quantity of sugar in the blood after some days of well 

 marked hypoglycsemia is explained on the supposition that 

 the blood becomes charged with sugar from the kidneys. 



9 E. Frank and S. Isaak, Verh. d. 17. Kongr. f. internal. Med., Wiesbaden, 

 1910, p. 586; Arch. f. exper. Pathol., 64, 274, 293, 1911. 



10 R. Lupine, C. R. Soc. de Biol., 68, 448, 1910. 



