GLYCOSURIA AND ADRENAL OVERACTIVITY. 365 



the end of the disease, when it is hardly equal to half of the 

 normal quantity; (2) that the C0 2 exhaled is likewise reduced." 

 That this is essentially due to suprarenal insufficiency i.e., 

 reduced oxidation is shown by the fact that, in a case of coma 

 due to meningitis witnessed by Stadelmann, the proportion of 

 C0 2 was 28.2 per cent.; while in diabetic coma the gradual 

 decline is that observed in Minkowski's rabbits, which, from the 

 normal 25 per cent., steadily dropped to 16, 8.8, then 2.9 per cent. 



We have seen that tetanus was due to excessive suprarenal 

 activity. Cartier refers to the experiments of Claude Bernard, 

 which showed that strychnine produced glycosuria in dogs. 

 "It is unnecessary to reproduce here," says Cartier, "the symp- 

 toms of poisoning produced by this alkaloid; we will simply 

 say that nothing recalls tetanus to such a high degree as does 

 intoxication by it." We have another proof that it is due to 

 an excessive production of a ferment or some other agency 

 possessed of converting powers since Langendorff found that 

 "glycosuria only occurs in frogs when the liver contains glyc- 

 ogen. ... In the summer, when their liver contains none, 

 strychnine does not cause diabetes in these animals." 



We are reminded of the disorganization of haemoglobin 

 produced by advanced suprarenal insufficiency when, referring 

 to curare glycosuria, Cartier says: "Others account for this 

 glycosuria by an insufficiency of the respiration and by slowing 

 of combustions. The dark coloration of curarized blood indi- 

 cates this asphyxia." Even the nervous distribution, as we 

 interpret it, including the connection between the anterior 

 pituitary body and the adrenals, finds itself sustained in a 

 remarkable manner by the following lines of Cartier's in ref- 

 erence to morphine glycosuria: "An extremely interesting 

 fact that all these investigations indicate is that one can 

 produce with a toxic substance exactly similar phenomena to 

 those recorded by Claude Bernard in his lessons at the .College 

 of France, and obtained by puncture of the medulla, and that 

 these toxic glycosurias can in most cases be arrested, as are 

 glycosurias of nervous origin, by severing the centrifugal nerve- 

 impulse conductors. Indeed, section of the pneumogastric 

 (centripetal nerve) does not prevent glycosuria caused either 

 by Bernard's puncture or by morphine; but, on the contrary, 



