GLYCOSURIA AND ADRENAL OVERACTIVITY. 363 



not be given this feature, inasmuch as we have personally seen 

 the typical symptoms of total suprarenal insufficiency occur 

 in a dog within twenty seconds after a fatal dose of hydro- 

 cyanide of potassium had been administered. Large quantities 

 of the less active drugs are more likely to reach the tissues 

 for which they possess a special predilection, bromide of 

 potassium, for instance, than such an agent as that pre- 

 viously mentioned. While, therefore, we cannot say that ex- 

 cessive formation of sugar, when drugs are given, is due only 

 to overstimulation of the adrenals, we can say that all drugs 

 can produce it when they stimulate suprarenal activity. Fur- 

 thermore, it seems probable that some drugs not only do this, 

 but they likewise, owing to their affinity for certain tissues, 

 enhance the production of sugar by increasing the functional 

 activity of the intimate structures of the organs concerned in 

 its production from ingested substances thus stimulating two 

 different sets of organs simultaneously. Such an agent we 

 probably have in phloridzin. 



In an able and exhaustive review of the subject of toxic 

 glycosuria, P. Cartier, 1 of Paris, says: "The symptomatology of 

 phloridzin is very limited, seeing that it does not give rise to a 

 true intoxication. ... In man it is even possible to bring 

 on glycosuria, and maintain it a long time, without giving rise 

 to general disorders, provided a copious alimentation is in- 

 sured." We have evidence in the last sentence that the main 

 general result is an excessive formation of sugar, and, more 

 carbohydrates being required, it is to an excessive production 

 of the converting agent that we must ascribe this phenomenon. 

 Still, if general symptoms are absent, what becomes of the 

 suprarenal overactivity? Cartier answers this question when 

 he says: "Yet all authors who have studied phloridzin unite 

 in saying that the animal experimented upon becomes voracious, 

 and, if not overfed, rapidly wastes. . . . When alimenta- 

 tion is insufficient, grave phenomena appear. Phloridzinic 

 glycosuria has been obtained in animals entirely deprived of 

 hydrocarbons; under these circumstances general symptoms 

 analogous to those of diabetic coma have been observed." 



1 F. Cartier: These de Paris, 1891. 



