DISTURBANCES OF CARBOHYDRATE METABOLISM 299 



The concentration of fructose in the urine may be as high as 3.5 per 

 cent but is generally less than 1.5 per cent. 



Since it is found in the urine, it is to be expected that fructose would 

 also be present in the blood. Rosin and Laband have, indeed, reported that 

 they observed this, but their figures are so remarkable, over 0.5 per cent 

 by polarization in the blood when there was only 1.4 per cent by reduc- 

 tion in the urine, as to make one suspect their analytical procedure. 

 Neuberg and Strauss reported the isolation of methylphenylfructosazone 

 from the serum, ascitic and pleural fluids of several different patients, par- 

 ticularly after the administration of fructose. These patients did not 

 exhibit a spontaneous fructosuria. A close examination of their figure 

 yields some interesting results. In their Expt. 4, 1,470 c.c. of pleural 

 fluid from a patient with lymphoma, but no fructosuria and not receiving 

 fructose, except in the quantities present in an ordinary diet, yielded 1.35 

 grams of the osazone. Since 2 grams of fructose added to 200 c.c. ascitic 

 fluid yielded 2.27 grams of osazone, the 1.35 grams of osazone represent 

 at least 1.19 grams of fructose or a content of 0.081 per cent in the pleural 

 fluid taken. The other experiments give similar results. In other words, 

 if the work of Neuberg and Strauss was valid, practically all of the 

 sugar of these fluids was fructose and little, if any, was present as glucose. 

 This is extremely improbable. It is much more likely that the osazone 

 was formed from glucose, particularly since Ofner obtained the osazone 

 from pure glucose under very similar conditions. The presence of fructose 

 in the body fluids is yet to be demonstrated. 



The ingestion of starch, lactose or glucose (Schlesinger, Neubauer(a), 

 Borchardt(&), 1909b) is without effect on the excretion of fructose. This 

 is increased by the administration "of fructose or its compound, sucrose 

 (cane-sugar) . The increase is not so great as the amount ingested. The 

 exact fraction eliminated appears to vary considerably. Neubauer found 

 that 16 per cent of any amount from 3.8 to 50 grams appeared in the 

 urine. But others (Schlesinger, Borchardt(6), Strouse and Friedman) 

 have found from 2 to 20 per cent of the amount ingested in the urine and 

 more with larger amounts than with smaller. Only Rosin and Laband 

 failed to find that the ingestion of fructose increased its excretion in 

 the urine. But their experimental work seems to have been decidedly 

 faulty and no great significance should be attached to their report. 



Treatment. The therapy is obvious : withdrawal of sucrose and honey 

 from the diet, and a limitation of the consumption of berries, fruits, etc. 

 The sugar then disappears from the urine or occurs in minimal amounts. 



Significance. Fructosuria is not an apparently harmless anomaly like 

 pentosuria. It is a real disorder and is to be compared to a mild diabetes. 

 However, there is no record of its developing into diabetes. The prog- 

 nosis is good. 



The claim of Cammidge that so-called urinary fructose is frequently 



