304 ADRENALS IN CARBOHYDRATE METABOLISM 



place as a physiological process. It is, therefore, not at all 

 surprising that Herter should have succeeded in bringing on 

 glycosuria by squeezing the normal adrenals in situ. 



Hypothesis of the Regulating Influence of Adrenin Upon 

 Normal Carbohydrate Metabolism. It is but a step from 

 this point to the proposition that the passage of the adrenin 

 from the adrenals into the blood stream has normally a 

 regulative influence upon carbohydrate metabolism. Thence 

 it is suggested that the adrenin having entered the circula- 

 tion normally from the adrenals excites the sympathetic 

 nerve terminations in the liver (in the same way as in elec- 

 tric irritation of the sympathetic, in the sugar puncture, in 

 stimulation of the central end of the vagus, in asphyxia, in 

 the effect of carbon monoxide, caffein and many of the 

 narcotics), 16 and that such a condition of stimulation can 

 under proper conditions give rise to a discharge of the 

 hepatic glycogen, to hyperglycaemia and to glycosuria. 



Does the Sugar Puncture Act Through the Adrenals to 

 Cause Glycosuria? From this point of view a line of thought 

 has been developed, that Claude Bernard's sugar puncture 

 may possibly not have a direct effect upon the liver, but may 

 perhaps act indirectly by way of the adrenals, inducing pri- 

 marily a massive output of adrenin from the adrenals into 

 the blood, with production in this way of a simple adrenin 

 glycosuria, in complete analogy to the effect of an intra- 

 venous injection of this very active substance into the cir- 

 culation. 



Soon after F. Blum, 17 the discoverer of adrenal diabetes, 

 published his belief that a close similarity exists between 

 this condition and glycosuria from Bernard's puncture, the 

 logical suggestion from which would be to investigate 

 whether the latter does not have its influence on the liver 



"E. Starkenstein (J. Pohl's Lab., Prague), Zeitschr. f. exper. PathoL, 

 10, 1911. 



17 F. Blum (Frankfurt, a. M.), Pfliiger's Arch., 90, 628, 1902. 



