v INTEKNAL KESTITUTIVE SECEETIONS 317 



while the phloretin unites once more with the circulating glucose, 

 the new phloridzin being again decomposed in its passage through 

 the renaltubules. 



Other intoxications are capable of producing glycosuria or 

 transitory diabetes, e.g. poisoning with curare, with a strong dose 

 of morphine, with amyl nitrite, carbon monoxide, and many other 

 poisons. These analogies and the differences between the various 

 processes which give rise to common symptoms of glycosuria have 

 not been sufficiently investigated. 



Another form of experimental diabetes presents a more striking 

 analogy with spontaneous diabetes; this was first discovered by 

 De Dominicis in Italy (1889), and simultaneously by v. Mering 

 and Minkowski in Germany. When the pancreas is entirely 

 removed in a dog (as also in other animals of different classes of 

 vertebrates), all collateral lesions being as far as possible avoided, 

 so that the animal is able to survive this grave operation, a severe 

 form of diabetes invariably sets in with all the characteristic 

 symptoms of spontaneous diabetes abnormal hunger and thirst, 

 polyuria, depression of muscular energy, etc. The elimination of 

 sugar does not usually begin immediately after the operation, but 

 in 4 to 6 hours, or even later, usually on the second day. It 

 rapidly increases in intensity, and reaches its maximum 24 to 48 

 hours after the operation with about 8 to 10 per cent of sugar in 

 the urine. If food is cut off, the elimination of sugar decreases, 

 but does not absolutely disappear till after 7 days' absolute fast. 

 With abundant food, the sugar eliminated by the kidneys may 

 amount to 10 to 12 per cent, and even more. With an exclusively 

 flesh diet, a dog of 15 kgrms. may excrete 102 grms. sugar per 

 diem. If bread be added to the meat, the absolute quantity of 

 sugar eliminated may be even greater, e.g. a dog of 8 kgrms. 

 excreted 70 to 80 grins, daily for a considerable period. As in 

 spontaneous diabetes, considerable quantities of acetone, acetic 

 acid, and oxybutyric acid are given off with the sugar. As in 

 spontaneous diabetes, there is conspicuous hyperglycaemia, e.g. in a 

 dog operated on six days previously there was 0'3 per cent, in 

 another, 27 days after operation, 0'46 per cent sugar in the blood. 

 The glycogen almost entirely disappears from the liver and muscles 

 after the operation ; but these organs do not lose their power of 

 forming it by synthesis, and also of accumulating it to some extent. 

 In fact new glycogen can be found in both liver and muscles, after 

 feeding with laevulose, which, as in spontaneous diabetes, can be 

 utilised and only partially escapes into the urine, and that after its 

 conversion into dextrose. Dextrose, however, if administered as a 

 food, reappears entirely in the urine. These facts have been gener- 

 ally confirmed by many observers, both in Italy and elsewhere. 

 Glycosuria has rarely been found absent after complete extirpation 

 of the pancreas (Cavazzani and others); sometimes after total 



