NATURE OF ADRENAL DIABETES 301 



from its clinical and physiological standpoints is sufficiently 

 explanatory of the flood of publications persisting even now 

 which had its beginning in this discovery. 



The glycosuric influence of suprarenin is appreciable only 

 when it is introduced subcutaneously, intravenously or intra- 

 peritoneally. When given by the mouth even large doses 

 are without effect upon the carbohydrate metabolism and 

 the blood pressure. The glycosuria is directly related with 

 the supply of glycogen in the liver and its liquidation. In- 

 jection of adrenin directly into a mesenteric vein acts, ac- 

 cording to Doyen, in an almost paroxysmal manner, although 

 in dogs with Eck's fistulas it produces neither hyperglycaemia 

 nor glycosuria. 2 Between the amount of adrenin present 

 in the blood and that of the sugar excreted in the urine there 

 exists within certain limits a direct ratio, according to 

 studies made in Straub's laboratory. The occurence of a 

 stage of latency is clearly due to the fact that a certain 

 amount of time is necessary to put the mechanism of sugar 

 mobilization in motion. Straub believes, as do others, that 

 the parts influenced by the adrenin are the same sympa- 

 thetic nerve fibres whose central irritation is responsible for 

 the effectiveness of the sugar puncture. 3 As the supra- 

 renin acts on the endings of the sympathetic fibres, one can 

 readily appreciate why splanchnicotomy does not prevent 

 its glycosuric effect. 4 What actually takes place is that the 

 liver under the influence of the poison passes its supply of 

 glycogen into solution; if this supply is an abundant one 

 (perhaps after preceding indulgence in carbohydrates) a 

 stream of sugar will pass out from the liver into the blood. 

 But if the store of glycogen has been used up through the 



3 Michaud (Kiel), Verb. d. Kongr. f. innere Med., Wiesbaden, 1911. 



3 W. S'traub, Miinchener med. Wochenschr., 1909, 493 ; H. Ritzmann, Arch, 

 f. exper. Pathol., 61, 231, 1909; cf. also F. P. Underbill and O. E. Closson (Yale 

 Univ., New Haven), Amer. Jour, of Physiol., 17, 421, 1906. 



4 Cf. L. Pollak (Pharm. Instit., Vienna), Arch. f. exper. Pathol., 61, 1909; 

 also the observations of K. Hirayama upon the interruption of sympathetic 

 conduction by nicotine: Zeitschr. f. exper. Pathol., 8, 649, 1911. 



