514 DISEASES OF THE INSULAR APPARATUS OF THE PANCREAS 



consumption of sugar on account of muscular work is only possible when 

 pancreatic tissue is still present in the organism. This conclusion is not, 

 however, very convincing, v. Noorden explained analogous observation in 

 human diabetes by the fact that as a consequence of oversensitiveness of 

 the sugar-forming apparatus the steady appeal of which to the liver for 

 much sugar during muscular work is answered in an excessive manner. 



The fact that the respiratory quotient after total extirpation of the pan- 

 creas is maintained at a very low level, and, as previously mentioned, 

 remains at this level in spite of administration of carbohydrates, was formerly 

 regarded as a chief argument for the disturbance of carbohydrate combustion. 

 v. Noorden mentions, however, that it has not as yet been shown that the 

 substance that undergoes combustion in muscle is not a sugar. What it has 

 been shown is only that the excretory product is not a nutritional carbohy- 

 drate; it may, however, be a fat. 



Also other authors express themselves as against a disturbance in sugar 

 combustion. Chauveau and Kaufman investigated the sugar contents in 

 the arterial and venous blood of pancreasless dogs, and found that of the 

 arterial blood higher. Investigations on the "sugar puncture" hypergly- 

 cemia yielded the same result. Forges and Salomon found in their experiments 

 that on exclusion of the entire portion of the body lying below the diaphragm, 

 the respiratory quotient in the pancreasless dog rose as high or as even higher 

 than in normal animals under the same conditions. As the combustion 

 under these conditions takes place chiefly in the muscles, they assume that 

 after removal of the pancreas, the muscles are in a condition to burn up sugar. 



Recently Knouthon and Starling have again entered the lists for a dis- 

 turbance of the sugar combustion in the pancreasless dog. If a heart-lung 

 preparation of a normal dog is transfused with normal blood, there occurs a 

 strong consumption of sugar. If, however, the heart-lung preparation of a 

 pancreasless dog is transfused with the normal blood, the consumption of 

 sugar straightway becomes o. If dealbuminized pancreas extract be ad- 

 ded to this blood, consumption of sugar reappears. Knouthon and Starling 

 conclude from this that tissue and blood contain a substance ordinarily 

 coming from the pancreas that is necessary for the sugar consumption in the 

 tissues. 



The experiments of Knouthon and Starling may be interpreted in two 

 ways: Either in normal dogs the sugar is burned, or it is polymerized and 

 assimilated. According to the interesting experiments of Levene and Meyer 

 the latter is not at all unlikely. For these authors showed that through 

 the combined action of muscle-plasma and pancreas extract, the power of 

 reduction of a sugar solution becomes reduced, but may be regained on 

 cooking with acids. 



The experiments also make necessary a revision of the important investi- 

 gations of Lepine on glycolysis. 



