THE Ml TABOLTSM OP I Hi CARBOHYDRAI 



level of ili»' blood ;in<l therefore a tendency to diabetes. There have 

 recently been collected several facts which lend Bome Bupporl t<> 1 1 1 i -• 

 view. The frequenl occurrence of diabetes in those predisposed by 

 inheritance t<> neurotic conditions, or in those whose daily habits entail 

 much nerve strain, and the aggravation of the Bymptoms which is lil i 

 to follow when a diabetic patienl experiences some oervoua shock, all 

 point in this direction. 



Diabetes is common in locomotive engineers ami in the captains 



ocean liners thai is, in men who in the performan i' their daily duties 



are frequently pu1 under a severe nerve strain. It is apparently in- 

 creasing in men engaged in occupations that demand mental concentra- 

 tion and strain. Buch as in professional and business work. Canno 

 found glycosuria in four ou1 of nine students after a severe examination, 

 bul only in one of them after an easier examination.* In the urines of 

 twenty-four members of a famous football squad, sugar was found p 

 -•lit in twelve immediately after a keenly contested game. Anxiety and 



excitement must have been responsible for it-- appearai since five of 



the twelve players were substitutes who did uot gel into the game. 



Although these nervous conditions, by excitement of hepatic glyco- 

 genosis, produce at first uothing more than an excessive discharge of 

 sugar into the blood — a condition which is exactly duplicated in our 

 laboratory experiments by stimulation of the nerve supply of the liver — 

 their repetition may gradually lead to the development of a permat 

 form of hyperglycemia. To prevenl the repetition of these transient 

 hyperglycemias musl be one of our aims in the treatment of early •' _ 

 of the disease. 



Although there can be no doubl thai the glycogenic function of the 

 liver is subject tn nerve control, it is probable that its control by I 

 mones is of equal if no1 greater importance. This dual control of a 

 glandular mechanism is by no means unique for the glycogenic functi 

 for we have already sen it to exisl in the case of thi ric glands 



and the pancreas, and i1 is probable thai ii also exists in tl 

 the thyroid. It may well be that the nerve control "t' the glycogenic 

 function 1ms to do only with those transitory cha gea juj luc- 



ti.ui that would be demanded by sudden activities nt* muscle, and that 

 the hormone control has in do with the more permanent pr< ' build- 



ing up ami breaking down nt" glycogen to meet the general olic 



requirements of the tissn 



' \\ . I unable i m Ihia 



