ALIMENTARY LAEVULOSURIA 283 



rarity. 35 Contrary statements can be clearly explained as 

 faults of observation. 36 



True Lcevulosuria. A spontaneous true laevulosuria 

 seems to be a very rare abnormality, seen beyond question 

 in only a very few cases, and cannot be said to be related 

 with diabetes. It may be influenced by ingestion of laevulose 

 or cane-sugar, but not of grape-sugar, and disappears on a 

 carbohydrate free diet. 37 



The significance of presence of laevulose in the amniotic 

 fluid and in the urine of new-born calves is unknown. 38 At- 

 tention has been called with propriety to the possibility that 

 the laevulose excreted by the calves in the first few days of 

 their lives may have come from amniotic fluid which they 

 swallowed. 39 



Alimentary Lcevulosuria. In the course of the last few 

 years a number of observations upon alimentary laevulosuria 

 have been collected, frequently occurring, as Strauss first 

 pointed out, along with disturbances of the hepatic function. 

 Thus a decrease in tolerance for laevulose has been met in 

 cirrhosis of the liver, in marked biliary stagnation, phos- 

 phorus poisoning, and analogous conditions. 40 The fact 

 that an alimentary laevulosuria is a frequent complication of 

 pregnancy (v. sup.) may also be suggestive of a hepatic 

 functional disturbance. Such functional faults are in sharp 

 contrast with true diabetes, as in this latter condition, as has 

 been seen, the tolerance for laevulose tends to be less dimin- 

 ished than that for dextrose. 



So much for laevulosuria. 



35 L. Borchardt, 1. c.; O. Adler, 1. c.; H. Malfatti, 1. c.; H. Chr. Geelumyden 

 (Christiania), Zeitschr. f. klin. Med., 70, 287, 1910. 



36 Cf . criticism by Borchardt upon the work of W. Voit, Zeitschr. f . physiol. 

 Chem., 58, 182, 1909; 60, 411, 1909, and reply thereto, ibid., 61, 92, 1909. 



37 Cf. Literature: F. Umber, 1. c., pp. 250-251, and Magnus-Levy, 1. c., 

 p. 391. 



88 L. Langstein and C. Neuberg, Biochem. Zeitschr., 4, 212, 1907. 

 M A. Magnus-Levy, 1. c., p. 390. 



40 Cf. Literature in F. Umber, Salkowski Festschr., 1904, and in H. Hohl- 

 weg (Giessen), Arch. f. klin. Med., 97, 443, 1909. 



