INTERNAL SECRETION AND DISORDERS OF LIVER 677 



muscle-glycogen content characteristic of an overnourished dog, and the 

 liver-glycogen content characteristic of inanition. The author concluded 

 that the muscles form glycogen and compensate for the loss of liver func- 

 tion in regard to glycogenesis. Hawk (1908) failed to find glycosuria 

 following the ingestion of carbohydrate food. Macleod (1908) estab- 

 lished Eck fistula? and did not observe glycosuria and later clamped 

 the portal vein for short intervals. Hypoglycemia but not glycosuria was 

 'found to result. Michaud (1911) found that the Eck fistula prevents 

 epinephrin glycosuria and also observed that the blood sugar remains nor- 

 mal or increases within normal limits after the ingestion of 100 gm. dex- 

 trose. Bernheim and Voegtlin (1912) found the carbohydrate tolerance 

 only slightly reduced. Sweet and Ringer (1913) state that after the ad- 

 ministration of phlorhizin glycosuria follows, resembling in every detail 

 that observed in normal dogs. This is contrary to the findings of Rosen- 

 feld (1907), who did not obtain any glycosuria at all. McGuigan and 

 Ross (1915-16) found that the utmost conceivable uncomplicated change 

 in the circulation of the liver can play but a minor role in the production 

 of glycosuria or diabetes. Jacobson (1920) concludes that glucose toler- 

 ance is only slightly modified in Eck fistula animals, while the levulose 

 tolerance is extremely low. The liver is essential for levulose metab- 

 olism, but not entirely essential for glucose metabolism. The muscles 

 perform well the functions of glycogenesis and glycogenolysis when the 

 liver is shunted out of the portal circulation. 



Hemoglobin Antecedents as Hepatic Internal Secretions 



Bile and Hemoglobin Formation. Voegtlin and Bernheim (a) (1911) 

 conclude that the jaundice and fatal toxemia resulting from occlusion of 

 the common bile duct can be avoided by an Eck fistula made at the time of 

 the ligation of the common bile duct. The amount of bile formed depends 

 on the blood flow through the liver and on the fact that the liver has a 

 hemolytic function. Whipple and Hooper (a) (1913) have shown that 

 simple obstruction of the common bile duct when combined with an Eck 

 fistula gives rise to a definite low grade icterus with bile pigments con- 

 stantly present in the urine. The formation of bile and bile pigments is 

 much less in an Eck fistula dog than in a normal animal, and, consequently, 

 the icterus is much less intense. They attribute this to a lessened activity of 

 the liver cells because of decreased blood supply and suggest that the bile 

 pigment may be formed in part from other substances than hemoglobin ; 

 further, that normally bile pigment formation may depend in part upon 

 the functional activity of the liver cell rather than upon the amount of 

 hemoglobin supplied to it. Furthermore', they show that normal and Eck 

 fistula dogs react in a similar manner to the intravenous injection of 



