PHLORHIZIN DIABETES. 379 



extent of preventing the passage of blood-sugar into the urine; and it 

 follows from this that an elimination of sugar in the urine may be caused 

 partly by a reduction or suppression of this above-mentioned activity, 

 and partly also by an abnormal increase of the quantity of sugar 

 in the blood. 



The first seems, according to v. MERINO and MINKOWSKI, to be the 

 case in phlorhizin diabetes, v. MERINO found that a strong glycosuria 

 appears in man and animals on the administration of the glucoside 

 phlorhizin. The sugar eliminated is not derived from the glucoside 

 alone. It is formed in the animal body, and in fact from the car- 

 bohydrates, or as generally admitted on prolonged starvation, from 

 the protein substances of the body (LUSK). The quantity of sugar in 

 the blood is not increased, but rather diminished, in phlorhizin diabetes 

 (MINKOWSKI), but this is disputed by PAVY. This last investigator 

 found, although only to a slight degree, that the sugar in the blood was 

 increased, but he holds the same view that v. MERINO does, that phlor- 

 hizin diabetes is a kidney diabetes. The fact that after extirpation of the 

 kidney in phlorhizin diabetes no rise in the blood-sugar is observed, and 

 that after the injection of phlorhizin in the renal artery of one side the 

 urine secreted by this kidney contains sugar sooner and more abundantly 

 than the urine from the other kidney (ZUNTZ), tends to favor this 

 view. The experiments especially performed by PAVY, BRODIE, and 

 SIAU l upon blood containing phlorhizin and surviving kidneys also 

 indicate the same, namely, that the phlorhizin acts upon the kidneys. 

 While v. MERINO believes in an increased permeability of the kidneys 

 for sugar, produced by the phlorhizin, PAVY is, on the contrary, of the 

 opinion that the kidneys, under the influence of the phlorhizin, split 

 off sugar from a substance circulating in the blood, perhaps from a pro- 

 tein with loosely combined carbohydrate groups. 



Another form of glycosuria which seems to be connected with a 

 changed permeability of the kidneys is the glycosuria first observed by 

 BOCK and HOFFMANN after the intravascular injection of large quantities 

 of a 1-per cent salt solution, which is also of great interest because, as 

 shown by MARTIN FISCHER, it can be again arrested by an injection of 



1 In regard to the literature on phlorhizin diabetes see v. Mering, Zeitschr. f. klin. 

 Med., 14 and 16; Minkowski, Arch. f. exp. Path. u. Pharm., 31; Moritz and Prausnitz, 

 Zeitschr. f. Biologic, 27 and 29; Kiilz and Wright, ibid., 27, 181; Cremer and Ritter, 

 ibid., 28 and 29; Contejean, Compt. rend, de soc. biol., 48; Lusk, Zeitschr. f. Biologic, 

 36 and 42: Levene, Journal of Physiol., 17; Pavy, ibid., 20, and with Brodie and 

 Siau, 29; Arteaga, Amer. Journ. of Physiol., 6; O. Loewi, Arch. f. exp. Path. u. 

 Pharm., 47; N. Zuntz, Arch. f. (Anat. u.) Physiol., 1895; Stiles and Lusk, Amer. Journ. 

 of Physiol., 10; Lusk, ibid., 22; Cremer, Ergebnisse der Physiol., 1, Abt. 1, and the 

 monographs upon diabetes. 



