384 THE LIVER. 



It seems as if not only does the liver stand in close relation to pan- 

 creas diabetes, but to other organs also. PFLUGER found that in 

 frogs, after total extirpation of the duodenum, a strong and continuous 

 glycosuria is the result, and HERLITZKA found the same after poison- 

 ing the central nerves of the duodenum of the frog by means of nicotine. 

 According to PFLUGER we can explain this glycosuria by the assumption 

 that the pancreas has an antidiabetic action which is influenced by the 

 nerve centers of the intestine. This relation of the duodenum to pan- 

 creas diabetes has not been generally admitted, and in warm-blooded 

 animals (at least in dogs) the occurrence of a duodenal diabetes has not 

 been shown. Still REALE and DE RENZI observed a glycosuria in 

 dogs after duodenal resection, but others have not been able to confirm 

 this, or at least only in part. PFLUGER, on carefully repeating REAL'S 

 and DE RENZI'S experiment, observed only a very slight or no glycosuria 

 at all, and previously EHRMANN, ROSENBERG and MINKOWSKI, in an 

 especially convincing manner, after the total extirpation of the duodenum 

 in dogs, obtained completely negative results. The positive results of 

 REAL and DE RENZI are explained by PFLUGER 1 by the healing up of 

 the intestinal tube and the disturbance produced in its neighborhood. 

 No positive conclusion can be drawn from the glycosuria observed by 

 GAULTIER and by ZAK after corrosion of the duodenal mucous membrane, 

 as a glycosuria can also be produced by the corrosion of other parts of 

 the intestine (EICHLER and SILBERGLEIT 2 ) . The occurrence of a duo- 

 denal glycosuria in dogs has thus far not been proven. 



There seems, on the contrary, to exist a relation between pancreas 

 diabetes and the function of the adrenals. As first shown by BLUM, 

 adrenalin produces a strong glycosuria which apparently brings about 

 an increase in the destruction of glycogen with hyperglycaBmia by an 

 abundant " mobilization of the carbohydrates. " This glycosuric action 

 of adrenalin could be prevented by ZUELZER by the injection of pan- 

 creas extracts, and this statement is confirmed by FRUGONI by exper- 

 iments with pancreatic juice. Further proof of the relation of the 

 adrenals to the pancreas has been given by EPPINGER, FALTA and RUPIN- 

 GER. 3 According to the last-mentioned investigators there is evidence 

 of a certain relation existing in pancreas diabetes between the pancreas, 

 adrenals and thyroids. According to them a mutual retarding action 

 exists between the pancreas and the thyroids as well as between the 



1 Pfluger in his Archives, 118, 119, 122, 124; Minkowski, Arch. f. exp. Path. u. 

 Pharm., 58. The other works cited are found in the above literature. 



2 Gaultier, Compt. rend. soc. biol., 64; Zak, Wien. klin. Wochenschr., 21; Eichler 

 and Silbergleit, Berlin, klin. Wochenschr., 1908. 



3 Frugoni, Berl. klin. W^ochenschr., 1908; Eppinger, Falta and Rudinger, Zeitschr. 

 f. klin. Med., 66, which also contains the literature on adrenalin diabetes. 



