380 THE LIVER. 



a salt solution containing CaCl 2 . According to the investigations of 

 UNDERBILL and CLOSSON l on rabbits, the injection of salt into the carotid 

 artery brings about a hyperglycaemia by a disturbance in respiration; 

 the injection of the salt solution into the ear vein causes on the contrary 

 a glycosuria with polyuria and a hypoglycaemia, and they account for 

 the salt-glycosuria produced in this manner by pointing to an increased 

 permeability of the kidneys. 



With the exception of these two forms of glycosuria, the phlorhizin 

 diabetes and the salt-glycosuria, and also the glycosuria produced by 

 uranium salts, all other forms of glycosuria or diabetes, as far as known 

 at present, depend on a hyperglyccemia. 



A hyperglycsemia may be caused in various ways. It may be caused, 

 for example, by the introduction of more sugar than the body can destroy. 



The ability of the animal body to assimilate the different varieties 

 of sugar has naturally a limit. If too much sugar is introduced into the 

 intestinal tract at one time, so that the so-called assimilation limit 

 (see Chapter IX, on absorption) is overreached, then the excess of absorbed 

 sugar passes into the urine. This form of glycosuria is called alimentary 

 glycosuria, 2 and it is caused by the passage of more sugar into the' blood 

 than the liver and other organs can destroy. 



As the liver cannot transform into glycogen all the sugar which comes 

 to it in these, to a certain extent physiological, alimentary glycosurias, 

 it is possible that a glycosuria may also be produced under pathological 

 conditions, even by a moderate amount of carbohydrate (100 grams 

 dextrose), which a healthy person could overcome. This is true, among 

 other cases, in various affections of the cerebral system and in certain 

 chronic poisonings. Certain observers include the lighter forms of 

 diabetes, where the sugar disappears from the urine when the carbohy- 

 drates are cut off as much as possible for the food, to this class of gly- 

 cosuria. 



A hyperglycsemia which passes into a glycosuria may also be brought 

 about by an excessive or sudden formation of sugar from the glycogen 

 and other substances within the animal body. 



To this group of glycosurias belongs, it seems, the adrenalin glycosuria, 

 in which an increased mobilization of the carbohydrate (glycogen) occurs. 

 The so-called piqure of BERNARD, and probably also those glycosurias 



1 Bock and Hoffmann, Arch. f. (Anat. u.) Physiol., 1871; M. Fischer, University 

 of California publications Physiol., 1903 and 1904, and Pfliiger's Arch., 106 and 109; 

 Underbill and Closson, Amer. Journ. of Physiol., 15, and Journ. of Biol. Chem., 4. 



2 In regard to alimentary glycosuria see Moritz, Arch. f. klin. Med., 46, which also 

 contains the earlier literature; B. Rosenberg, Ueber das Vorkommen der alimentaren 

 Glykosurie, etc. (Inaug.-Dissert. Berlin, 1897); van Oondt, Munch, med. Wochen- 

 schr., 1898; v. Noorden, Die Zuckerkrankheit, 3. Aufl., 1901. 



