DISTURBANCES OF CARBOHYDRATE METABOLISM 305 



into the ozone and this again into the sugar. If this report is correct, 

 it not only proves the existence of an entirely new kind of metabolic 

 anomaly, but it may also require modification of some of our ideas regard- 

 ing the intermediary metabolism of fatty acids. It is difficult to imagine 

 any other source but these for the origin of an optically inactive heptose. 

 Inosituria. Inosite, though not chemically a sugar, is composed of 

 the same number of carbon, hydrogen and oxygen atoms as is glucose. 

 That it stands in some physiological relation to glucose is indicated by 

 the fact that, in the phlorhizinized dog, its subcutaneous administration is 

 followed by an increased excretion of glucose, which becomes greater as 

 the administration of inosite is continued. Most of it, however, is excreted 

 unchanged both by the normal and the phlorhizinized dog (Greenwald and 

 Weiss). Similar evidence of its poor utilization was obtained by Ander- 

 son. The reported excretion of 18 to 20 grams of inosite in the urine of 

 a diabetic, in which it gradually replaced the glucose, is, therefore, all 

 the more remarkable (Vohl). 



Small quantities of inosite have been found in the tissues, particularly 

 in the muscles, but the significance thereof is not evident. Its occurrence 

 in the urine has most frequently been reported in connection with polyuria, 

 as in diabetes mellitus, insipidus, albuminuria (Cloetta, Gallois). But 

 Magnus-Levy (/) was unable to isolate it from the urine of any of his 

 patients with diabetes insipidus and Kiilz(a) (1874-5) found it only occa- 

 sionally. On the other hand, Starkenstein(a) regarded it as a constituent 

 of normal urine. Whether these differences depend upon differences in 

 technic, or upon differences in the diets of the patients, it is difficult to 

 determine. At any rate, the significance of inosite in the human economy 

 is problematical. 



Glycuronic Acid in the Urine. Glycuronic acid is derived from 

 glucose by the oxidation of the terminal alcohol to an acid group. The 

 aldehyd group, which might be expected to be the more readily oxidized, 

 is unchanged. This is probably due to the fact that glucose combines 

 through the aldehyd group with phenol, menthol, thymol or any one of a 

 large number of substances, and that the oxidation takes place subse- 

 quently. Free glycuronic acid is not found in nature. It is always in 

 combination as in phenolglycuronic acid, etc. The purpose of this com- 

 bination is, presumably, detoxication. It is supposed to occur chiefly 

 in the liver, and a failure of the organism to respond to the administration 

 of camphor by the prompt excretion of the usual amount of conjugate 

 glycuronic acid, has been used as a test of hepatic function (Gautier). 



Cammidge Reaction. Cammidge described a reaction in the urine 

 which he considered to be valuable in the diagnosis of pancreatitis. The 

 exact technic has been modified from time to time but, in its essentials, it 

 depends upon the presence of a substance forming a phenylosazone in the 

 hydrolyzed filtrate from a lead acetate precipitation of the urine. With- 



