42 APPLIED PHYSIOLOGY 



fats as a possible source of sugar, though this view as 

 yet lacks actual confirmation. How important a solution 

 of the problem would be to the physician in affording 

 him guidance in the dietetic treatment of diabetes need 

 not be pointed out. 



Relation of the Pancreas to Carbohydrate Meta- 

 bolism. When first it was discovered that complete 

 removal of the pancreas resulted in permanent glycos- 

 uria, and when subsequent histological investigation 

 showed the almost invariable presence of lesions of the 

 islands of Langerhans in patients who had died of 

 diabetes, a great step forward in our knowledge of carbo- 

 hydrate metabolism had certainly been made. Up to the 

 present, however, the therapeutic results of this increase 

 of knowledge have been disappointing. Experience 

 showed that the administration of pancreatic extracts in 

 all forms and in all ways, or even transplantation of the 

 gland, failed to exert any influence on the course of 

 diabetes. It would appear, then, that it is not by the 

 mere elaboration of an internal secretion that the 

 pancreas promotes the utilization of sugar. Nor, 

 apparently, is it by neutralizing some ' toxin,' for the 

 injection of the blood of depancreatized animals into 

 those of others does not induce the disease. The view 

 that the pancreas produces some secretion which activates 

 a ferment in the muscles, which ferment is the active 

 agent in glycolysis or the katabolism of sugar, has also 

 fallen into disrepute, and the two most probable solutions 

 of the puzzle are that the pancreas produces a ferment 

 which (1) either promotes the polymerization of sugar 

 into glycogen, or (2) restrains the disintegration of 



