868 



JOHN K. WILLIAMS 



ance of alimentary glycosuria. Injections of extracts of the posterior 

 lobe in these experimental animals were also without effect on the sugar 

 tolerance. It is quite probable that the ability to utilize carbohydrates 

 can be more accurately determined by studying the blood sugar curve 

 after the oral ingestion of a definite amount of sugar as suggested by 

 Hamman and Hirschman, and Janney, than by merely estimating gluco- 

 suria. 



In Williams' case numerous blood sugar tests were made with the pa- 

 tient on both moderate and excessive carbohydrate diets which included 

 the ingestion of much cane sugar. The range of these tests was always 



Blood 

 Sugar 



Figure No. 1 - Glucose Utilization Test on a Case 

 of Diabetes Znsipidus. 



.18 

 .16 

 .14 

 .12 

 .10 



Hour 



24 



Fig. 1. The patient was given orally, after a night's fast, 107 grams of glucose 

 dissolved in 240 c.c. of water. Samples of blood and urine were taken immediately 

 before the ingestion of the test meal and after at half hour intervals for two hours 

 and at the end of 24 hours. No sugar appeared in the urine. The blood sugar curve 

 is slightly higher than is observed in a normal individual for two hours, suggesting 

 slightly defective utilization, but it returned to normal within 24 hours. 



within the normal limits, from 0.08 to 0.11 per cent. A glucose toler- 

 ance test performed in this case gave a curve slightly higher than normal 

 (see Figure No. 1), suggesting, if anything, diminished tolerance. There 

 can be no question but that this patient has disturbance of function in 

 the brain areas about the hypophysis, evidenced by the various dystrophies 

 and eye changes present. The constancy and importance of increased 

 carbohydrate tolerance as a symptom of diabetes insipidus may therefore 

 be questioned. It is possible, as Gushing has pointed out, that cases may 

 pass from the hypopituitarism stage to that of hyperpituitarism ; or it 

 may be that the hypophysis is not involved as has been suggested by several 

 workers. 



The specific gravity of the blood is said to be increased in some cases 

 of diabetes insipidus due chiefly to the accumulation therein of non- 

 colloid salts. The blood of normal individuals varies from 1.040 to 1.065 



