PANCREAS DIABETES. 405 



ability of the liver in diabetes to use fructose and not glucose in the 

 formation of glycogen is, according to E. NEUBAUER, 1 not characteristic 

 for diabetes, because it also occurs in phosphorus poisoning. Whether 

 the different behavior of the two kinds of sugar actually depends upon 

 a diminished ability of the liver in diabetes to form glycogen from glucose 

 or to another unknown circumstance has not been sufficiently proved. 

 In experiments on tortoise livers, by perfusion of RINGER'S solution con- 

 taining sugar, NISHI 2 found that the livers of diabetic animals formed 

 as much glycogen as the livers of normal animals. These results, which 

 cannot be applied to other animals, require at least further investiga- 

 tion. 



The relation of the pancreas to diabetic glycosuria is of the greatest 

 importance for its proper understanding. 



The investigations of MINKOWSKI, v. MERINO, DOMINICIS, and later 

 of many other investigators, 3 show that a true diabetes of a severe 

 kind is caused by the total or almost total extirpation of the pancreas 

 of many animals, especially dogs. As in man in severe forms of diabetes, 

 so also in dogs with pancreatic diabetes, an abundant elimination of 

 sugar takes place even on the complete exclusion of carbohydrates from 

 the food. 



Artificial pancreas diabetes may indeed also in other respects present 

 the same picture as diabetes in man, but there exist important differences 

 between these two. 4 It is generally accepted that in pancreas diabetes 

 a diminished consumption exists, i.e., diminished utilization, which 

 does not exclude an increased sugar formation from other bodies not 

 carbohydrates. 



Many important observations show that a close relation exists between 

 the liver and pancreas diabetes. PFLUGER has also especially shown 

 that in diabetes produced by SANDMEYER'S method (partial extirpa- 

 tion with subsequent destruction of the remains of the gland in the abdom- 

 inal cavity, when the animal remains alive for a longer time than after 

 total extirpation) the liver does not lose weight, although the total weight 

 of the animal diminishes greatly, while in starvation without diabetes 



1 Arch. f. exp. Path. u. Pharm., 61. 



2 Ibid., 62. 



3 See Minkowski, Untersuchungen iiber Diabetes mellitus nach Exstirpation des 

 Pankreas (Leipzig, 1893); v. Noorden, Die Zuckerkrankheit (Berlin, 1901), which 

 contains a very complete index of the literature. In regard to diabetes see also Cl. 

 Bernard, Leons sur le diabete (Paris), Seegen, Die Zuckerbildung im Thierkorper 

 (Berlin, 1890), and Pfluger, Des Glykogen, 2. Aufl., 1905, and especially v. Noorden's 

 Hanb. d. Pathol. des Stoffwechsels, 2. Aufl., 1907, Bd. 2, Chapter I. 



4 See Falta " Ueber den Eiweissumsatz beirn Diabetes mellitus." Berl. klin. Woch- 

 enschr., 1908, and Zeitschr. f. klin. Med., 66; Gigon, Deutsch. Arch. f. klin. Med., 97. 



