ON GLYCOSURIA AND DIABETES 273 



from which to date the commencement of involutionary 

 change, and the necessity for altering the course of life 

 in relation to physical exertion, mental effort, and the 

 continuance of the worries of life, with all that represent 

 pathogenic factors in the economy of tissue change and 

 metabolism. 



In like manner diabetes may represent only an aggra- 

 vated and more or less permanent establishment of the 

 condition here described as glycosuria, or it may represent 

 a condition of an acutely pathological character in which 

 the phenomena of tissue change and katabolism follow 

 each other in such rapid succession that body weight is 

 reduced at such a rapid rate that normal metabolism, 

 however abundantly ministered to by raw material, becomes 

 quite unable to keep pace with physiological requirements, 

 and life flickers out amid scenes of involutionary tissue 

 change, and chemical resolution of alimentary material, 

 into saccharine excretion of the most alarming intensity 

 and of the most wholesale character and proportions, in 

 which treatment proves as futile as the play of a single 

 fire-engine in a great conflagration. In this condition of 

 pathological things, alimentary materials do not reach the 

 tissues, being snatched up, as it were, by a pre-metabolic 

 resolvant chemico-pathological activity, which sweeps them 

 almost in toto through the kidneys, leaving the tissues to 

 pine away and perish from inanition, deprived of their 

 nutritive pabulum and wasted by pathological katabolism. 

 At this stage of development of the disease the affected 

 organism has become or is now a huge chemico-patho- 

 logical laboratory, in which are simultaneously being 

 performed the synthetic and analytic processes of saccharine 

 or glycerinoid production to meet the morbid ends of 

 some as yet unknown subtle disease factor or factors, the 

 satisfaction of which usually culminates in materio-dynamic 

 exhaustion and death. 



We may, thus, compare diabetes to cancer, in that it 

 converts the physiological tissues, and the raw elements 

 of nutrition, with their inherent dynamic powers and 

 energies, into the elements of its own specific pathological 

 individuality and morbid being with the universal 

 result, the destruction of their subject passing them out 



