678 DIABETES 



in diabetes glucose fails to interact with the products mentioned 

 because the glucose is not sufficiently dissociated. Another inter- 

 pretation has been to the effect that the sugar simply causes a com- 

 pensatory decrease of the fat metabolism, i. e., spare fat, thereby 

 decreasing the formation of the acidosis bodies. The mechanism of 

 the process is in any case still a theme for research. 



There are numerous other theories of diabetes, for the presentation 

 of which the reader is referred to the larger works. Lepine has long 

 stood for the view that the pancreas secretes a glycolytic oxidizing 

 ferment. Naunyn's theory pays particular regard to the ability of 

 the body to "fix" glycogen, while glycogen formation is held to be 

 a necessary preliminary step in the utilization of sugar. The failure 

 to fix glycogen he calls "diszoamylie," and the other metabolic dis- 

 turbances he regards as sequences. The complex development of 

 this same general idea by von Noorden, with the added element of 

 primary sugar overproduction, has already been alluded to. Pavy 

 saw in the diabetic a failure to assimilate sugar; that is, a failure of 

 the body to incorporate sugar in a colloidal combination which would 

 at once permit of its transportation to the points of utilization, and 

 prevent its premature excretion. The assimilation he held occurred 

 in the villi of the intestines, and the lymphocytes he regarded as the 

 morphologic elements which carry the sugar. Cohnheim's theory 

 that the muscle formed glycolytic enzymes, for which the pancreas 

 supplies an essential activator, is without any substantial experimental 

 support at the present writing. Allen proposed that the pancreas 

 supplies an "amboceptor" which is essential for the proper colloidal 

 blood sugar combination. For a thorough discussion of the basal 

 metabolism in diabetes melitus and its variations during changes of 

 diet, etc., the reader is referred to the studies of Benedict, Lusk, Du- 

 Bois, Allen and others, references to which are given in Allen's mono- 

 graph. 



Bronzed diabetes, the name given to that form of hemochromatosis 

 in which, along with the hepatic cirrhosis, there is an associated fibrosis 

 of the pancreas, and, as a result of this, the symptoms of pancreatic 

 diabetes, will be found discussed under the heading" hemochromatosis, " 

 chapter xviii. 



Diabetic coma is discussed under "acid intoxication," chapterjxx. 



Lipemia, which is observed frequently and most severely in diabetes, 

 Ls discussed in chapter xvi. 



Glycogen in pathological processes is discussed in chapter xvi. 



