DIABETIC LIP^EMIA 373 



there may be manifested a certain antagonism between 

 glycogen and fat, the site left vacant by the disappearance 

 of the glycogen coming to be occupied by the fat (not so 

 much in the anatomical sense as functionally, in the view 

 taken by G. Bosenf eld) . This point will be again taken up in 

 connection with fatty degeneration. The classical example 

 of this type of fat mobilization is seen in the lipaemia of the 

 Bhine salmon (during their migration without food) ob- 

 served by Miescher. In starving mammals the time of li- 

 paemic occurrence perhaps may be regarded as correspond- 

 ing with the time when the supply of carbohydrate has 

 become completely exhausted. 60 



Diabetic Lipcemia. It is not easy to see why a mobiliza- 

 tion of fats should not be assumed also for the lipsemia in 

 phloridzin diabetes, in that due to removal of the pancreas, 61 

 and in protracted diabetic coma. 62 Diabetic coma seems in 

 the vast majority of cases to be associated with lipaemia, in 

 which the amount of fat in the blood may reach an enormous 

 grade of twenty per cent, or more; the blood assuming an 

 appearance not unlike cream and chocolate, and on ophthal- 

 moscopic examination the retina showing directly a milky 

 turbidity. According to G. Klemperer in suchj cases we are 

 really dealing with a lipoidsemia rather than a lipaemia, the 

 bulk of the ethereal extract consisting, not of fat, but of 

 cholesterine and lecithin. For this reason he would in- 

 terpret diabetic lipaemia not so much as a phenomenon of 

 mobilization of fat deposit as of the cellular lipoids and as 

 evidence of increased cellular disintegration. 63 Other ob- 

 servers do not express themselves upon this point in by any 

 means as dogmatic a manner. Thus an examination of the 

 blood in a case of pancreatic diabetes showed that the 



80 F. N. Schulz, Pfliiger's Arch., 65, 299, 1897; W. Daddi (W. Aducco's 

 Lab.) , Lo S'perimentale, 52, 43, 1898. 



61 L. Lattes (Turin), Arch. f. exper. Pathol., 66, 132, 1911, and earlier 

 investigators. 



62 L. Schwarz (Prague), Deutsch. Arch. f. klin. Med., 76, 233, 1903; 

 G. Klemperer and H. Umber, Zeitschr. f. klin. Med., 61, 145, 1907; 65, 340, 1908. 



88 G. Klemperer, Deutsch. med. Wochenschr., 1910, 2373. 



