730 FRANCIS H. McCRUDDEN 



of the pancreas increases the rate of sugar oxidation; and that normally 

 the two tendencies inhibiting and stimulating just balance (Eppinger, 

 Falta and Rudinger). Hyperglycenria is attributed to diminished glucose 

 destruction resulting from a relative preponderance of adrenal activity. 

 In accordance with this hypothesis, progressive muscular dystrophy might 

 be attributed to a relative preponderance of pancreatic activity. But 

 epinephrin does not decrease the rate of glucose oxidation, on the con- 

 trary, it increases it (Lusk(c)) ; and all evidence points to diminished 

 glucose formation and not augmented glucose destruction as the cause of 

 the hyperglycemia in progressive muscular dystrophy. 



Progressive Muscular Atrophy 



Progressive muscular atrophy is a disease of the central nervous 

 system ; the metabolism changes are secondary. The presence of creatin in 

 the urine in this disease has long been known. In two cases reported by 

 McCrudden and Sargent (6), the average daily quantities were 0.198 gram 

 and 0.130 gram respectively. The blood sugar is normal, 0.111, 0.129, 

 and 0.179 per cent respectively, in three cases reported by McCrudden 

 and Sargent (6). The blood cholesterin is likewise normal. 



As in other cases, the creatinuria indicates impaired glucose oxidation. 

 In this case it is secondary, due to the fact that the muscles cannot func- 

 tion; glucose, though present in sufficient quantities, cannot be utilized. 



Myasthenia Gravis 



The metabolism data for myasthenia gravis are scanty. In two cases 

 reported by McCrudden and Sargent (6), the blood sugar was 0.0818 and 

 0.095 respectively. These amounts average at about the very lowest 

 limits for normal reported by the same authors. Creatin is not found 

 in the urine (McCrudden and Sargent(fc) and Gibson, Martin, and Buell). 

 A low creatinin coefficient and a negative calcium balance have been 

 found in this disease (Diller and Roseubloom; Pemberton(a) ; Gibson, 

 Martin, and Buell). 



Amyotonia Congenita 



Practically the only metabolic abnormality observed in this disease 

 is a decrease in the creatinin excretion (Gittings and Pemberton, Pem- 

 berton(&) ; Powis and Raper, Spriggs; Ziegler and Pearce). The low 

 creatinin is probably secondary to the atrophic condition of the muscles. 



