/'.I \r/,'/;.iN hiMii:Ti:s .i\/> m \iu:ti:s \ii:i.iTUi^ 667 



jrlinimcr of success ajjpcarcd to liavc altcndcd the iiilravcuous use of 

 an extract made 1»\ Zurl/.ci-. ■ ■ although delclci'ioiis hy-cffects occurred, 

 and the apparent ini])rovenient could have been due wliolly to reten- 

 tion. According to lledon and Drennan, amelioration of tiio severity 

 of pancreas diabetes as evidenced by a dimimition of glycosuria has 

 followed the transfusion of blood from a healthy animal or the injec- 

 tion of fresh detibrinated blood, and Forschbach. working with a 

 ])arabiosis (or two animals so joined by oi)erative means that pei-ma- 

 nent intermingling of their blood occurs) performed pancreatectomy 

 ill one of the animals without producing diabetes in either; from which 

 it might seem that the internal secretion was carried by the blood. 

 Ill harmony with these results were the investigations of Knowlton 

 and Starling,''* who found that an isolated beating heart taken from 

 a depancreatized animal (cat) was capable of removing less sugar 

 from the blood used as a perfusion medium than are hearts of normal 

 animals, but these latter experiments have not been confirmed and are 

 subject to criticism. Tn most of the transfusion experiments re- 

 ported the standardization of the metabolism prior to giving the fresh 

 blood has not been such as to make the results certain. Carlson and 

 Drennan found that pancreatectomy in a pregnant animal near term 

 might fail to cause diabetes, but that diabetes developed at once fol- 

 lowing delivery. This could be explained on the basis that an in- 

 ternal secretion passed from fetus to mother, or that sugar failing of 

 utilization in the mother was utilized by the fetuses. Kramer and 

 JNTurlin failed to note any increase of the respiratory quotient in de- 

 pancreatized dogs following blood transfusion, and Sansum and 

 Woodyatt saw no improvement following transfusion in a human 

 case."" 



Symptoms. — Tn the absence of extracts which contain the active 

 ]iriiici]ile in measurable fpiantity, the attention must be turned to a 

 more detailed study of the effects which follow its lack. Now it is 

 well known that in diabetes melitus there are all grades of severity. 

 WTiai follows has reference onily to the severest cases — those ivhich 

 maif hr called "complete diahetes." In the severest cases of dia- 

 betes, glycosuria ])ersists even when the individual subsists on a fat- 

 protein diet, and after the glycogen in the body has been reduced to 

 a mere trace. When this stage has been reached, and provided no 

 carbohydrate food is eaten, it is found that tlie total glucose in the 

 urine bears from day to day a constant ratio to the total nitrogen in 

 ihe urine as.already described for })lilorhizin dialietes. This "G :N" 

 ratio" is not always the same. Tn depancreatized dogs nourished 

 solely on fat and protein, it is often found, as Minkowski first recog- 

 nized, at 2.8 :1, and in human diabetes the same value for G : N is 



•-••iZoit. f. oxp. Pali).. innS-n (5), .107. 



54 .Tom-, of Physiol., 1913 (45), 140. 



55 Jour. Amer. Med. Assoc, 1914 (62), 006 for lit. references. 



