THE URINE. 407 



and in specially large amounts, it must be considered as an abnor- 

 mal constituent. 



Small amounts of glucose may pass into the urine from an ex- 

 cessive supply of sugar when the body, by absorption from the 

 intestines, takes up more sugar than it can assimilate (WORM 

 MULLER; F. HOFMEISTER, DE JONG). Also after starchy food 

 HOFMEISTER observed in dogs, whose power of assimilating sugar 

 had been greatly reduced by the almost complete withdrawal of 

 food for several days, that glycosuria appeared (STARVATION-DIA- 

 BETES according to HOFMEISTER). In man the appearance of 

 glucose in the urine has been observed in numerous and various 

 pathological conditions, such as lesions of the brain and especially 

 of the medulla oblongata, abnormal circulation in the abdomen, 

 heart and lung diseases, cirrhosis of the liver, cholera, etc., etc. 

 Glycosuria has also been produced in animals in various ways, as 

 by puncture of the fourth ventricle (piqure), cutting through the 

 spinal marrow, irritation of the pneumogastric nerve, poisoning 

 with carbon monoxide, curare, amyl-nitrite, o-nitro-phenyl-propiolic 

 acid, phloridzin, and many other substances, also by the injection 

 of dilute common-salt solution into the blood-vessels, and in many 

 other ways. The observation of v. MERING and MINKOWSKI that 

 in dogs after total extirpation of the pancreas a very copious and 

 continuous secretion of sugar, a true diabetes, appears is of special 

 interest. 



The continuous appearance of sugar in human urine, sometimes 

 in very considerable amounts, occurs in DIABETES MELLITUS. In 

 this disease there may be an elimination of 1 kilogramme of grape- 

 sugar during the 24 hours, or even more. In the beginning of the 

 disease, when the quantity of sugar is still very small, the urine 

 often does not appear abnormal. In more developed, typical cases 

 the quantity of urine voided increases considerably to 3-6-10 litres 

 per 24 hours. The percentage of the physiological constituents is 

 as a rule very low, while their absolute daily quantity is increased. 

 The urine is pale, but of a high specific gravity, 1.030-1.040 or 

 even higher. The high specific gravity depends upon the sugar 

 present, which varies in different cases, but may even amount to 

 The urine is therefore characterized in typical cases of dia- 



