CARBOHYDRATES. 95 



and, as a matter of fact, it seems probable that the principal cause of 

 glucohemia and the resulting glucosuria is that the organism has lost the 

 power of splitting the sugar molecule. The complete combustion of the 

 glucose molecule is, according to this view, always dependent upon a 

 previous hydrolysis, or some attack which loosens up the sugar molecule 

 and disturbs the condition of equilibrium; without some such action the 

 combustion cannot take place in the organism. This assumption is sub- 

 stantiated by the fact that glucose is very readily consumed by the healthy 

 organism, even more readily than is the case with other foods. Thus in 

 phosphorus poisoning, the oxidizing power is lost to a considerable extent 

 without the appearance of glucosuria. 



We have again come back to the undecided question concerning the 

 normal breaking down of sugar. The answer depends upon the explana- 

 tion of the inability of diabetics to break up glucose. It is easy to con- 

 ceive that the principal places of sugar consumption, the muscles, produce 

 a ferment which serves first of all to loosen up the glucose molecule and 

 thus prepare it for oxidation. That the glucose is not itself directly 

 oxidized is very plausible. In this way, the sugar stores in the organism 

 are in a measure protected. Only at the moment of the expenditure of 

 energy do the muscular cells prepare the dextrose molecule for consump- 

 tion. As to why the diabetic has lost this power, whether the ferment 

 which starts the process is missing, or whether he has lost the power of 

 activating this ferment, are questions which cannot be answered positively 

 at the present time. An important observation has been made that when 

 cane-sugar is taken into the system often only one half of the molecule 

 appears subsequently in the urine. This is due to the fact that many 

 diabetics are able to oxidize and assimilate fructose without difficulty. 1 

 In fact, because the liver can in such cases take care of fructose and not of 

 glucose, it has been proposed to feed diabetics a carbohydrate, such as 

 inulin, which on being hydrolysed yields fructose rather than glucose. 

 Unfortunately, however, the above carbohydrate is so difficultly digestible, 

 that the experiment has not met with much success. 2 At all events, it is 

 most remarkable that the liver should transfer fructose into glycogen, 

 a process which according to the generally accepted opinion involves the 

 intermediate formation of glucose; and yet should not be able to use the 

 glucose which it receives as such. 



1 E. Kiilz: Beitrage zur Pathologie und Therapie des Diabetes mellitus, p. 130, Mar- 

 burg, 1874. Worm-Muller: Pfliiger's Arch. 34, 576 (1884); 36, 172 (1885). F. Hof- 

 meister: Arch, exper. Path. Pharm.. 25, 240 (1889). J. Haycraft: Z. physiol. Chem. 

 19, 137 (1894). Minkowski: Arch, exper. Path. Pharm. 31, 158 (1898). Sandmeyer: 

 Z. Biol. 31, 12 (31) (1894). Fr. Voit: Z. Biol. 29, 147 (1892). Socin: Wie verhalten 

 sich Diabetiker Lavulose- und Milchzuckerfiitterung gegeniiber? Dissert. Strassburg, 

 1894. 



3 Sandmeyer: loc. tit. and Miura: Z. Biol. 32, 279 (1895). 



