440 ACETONE BODIES 



cially such theories as that of Geelmuyden, who first urged 

 the idea that carbohydrates and acetone bodies unite syn- 

 thetically to form a combination which is essential for the 

 further exchange of the acetone bodies, and then undertook 

 to show that acetone bodies are convertible in the body into 

 carbohydrates, and that they constitute a transition stage in 

 the supposed transformation of fat into carbohydrates. It 

 seems more likely that the observed fact that subcutaneous 

 injection of diacetic acid or /2-oxybutyric acid in animals 

 poisoned with phloridzin increases the output of sugar in 

 the urine, is explicable on the supposition of a tonic increase 

 of protein decomposition, rather than upon the assumption 

 of Geelmuyden that there occurs a sugar synthesis from 

 acetone bodies. 20 



According to J. Bar simple withdrawal of carbohydrates 

 is followed in normal human beings accustomed to a mixed 

 diet, and also in apes, by an acidosis, that is, by an excretion 

 of acetone, diacetic and oxybutyric acids, along with coinci- 

 dent increase in the ammonia, elimination. In the dog, goat 

 and pig acidosis does not show upon mere reduction of carbo- 

 hydrate, but is induced by combining phloridzin intoxication 

 with fasting. 21 



Diabetic Coma. As is well known diabetic coma, a symp- 

 tom complex clearly described many years ago by Kussmaul, 

 has been recognized, especially from the investigations of 

 Stadelmann and the Naunyn school, as an acid intoxication 

 caused by an accumulation in the system of acetone bodies. 22 

 Magnus-Levy, 23 who took a prominent part in these investi- 

 gations, showed that oxybutyric acid appears in the urine 

 of all severe cases of diabetes, even apart from the coma, 



20 H. C. Geelmuyden (Christiania), Zeitschr. f. physiol. Chem., 41, 128, 

 1904; 73, 176, 1911. 



21 J. Bar (Med. Clinic, Strassburg), Arch. f. exper. Pathol., 54, 153, 1905. 



22 Literature upon Acetone Bodies in Diabetic Coma: C. v. Noorden, Handb. 

 d. Pathol. d. Stoffw., 2d ed., 2, 69-86, 1907. 



23 A. Magnus-Levy, 1. c. ; Arch, f . exper. Pathol., 41 and J^o. 



