400 THE LIVER. 



sugar in the blood rises above this average, sugar passes into the urine, 

 sometimes even with slight rise and in other cases with stronger rise. 

 The. kidneys have the property to a certain 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, and others 

 to be the case in phlorhizin diabetes, v. MERING 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 

 carbohydrates, 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), which does not indicate increase in the sugar production 

 but rather an increased excretion of the sugar by the kidneys. 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 upon blood containing phlorhizin and sur- 

 viving kidneys also indicate the same, namely, that the phlorhizin acts 

 upon the kidneys and the researches of ERLANDSEN also lead to the same 

 conclusion. He found that on combining the phlorhizin action with 

 bleeding that the glycosuria was increased while after bleeding alone 

 without phlorhizin poisoning the hyperglycaBmia was absent. While 

 v. MERING and others believe in an increased permeability of the kidneys 

 for sugar, produced by the phlorhizin LEPINE l is of the view that the 

 phlorhizin causes a formation of glucose from the virtual sugar in the 

 kidneys. PAVY is, on the contrary, of the opinion that the kidneys, 

 under the influence of the phlorhizin, split off sugar from a substance 



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 Rioter, 

 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; Erlandsen, Bioch. 

 Zeitschr., 23 and 24; Lupine, Compt. rend. soc. biol., 68; Lusk, Ergebnisse der PhysioL, 

 Bd. 12, 315-392, and the monographs upon diabetes. 



