534 DIGESTION. 



ROHMANN and NAGANO. It is, therefore, not remarkable that disac- 

 charides, as well, have been found in the urine in cases of alimentary 

 glycosuria. 1 



The investigations of LUDWIG and v. MERING and others have 

 explained how the sugars enter into the blood-stream, namely, that they 

 as well as other bodies soluble in water do not ordinarily pass over into 

 the chylous vessels in measurable quantities, but are chiefly taken up by 

 the blood in the capillaries of the villi, and in this way pass into the mass 

 of the blood. These investigations have been confirmed by observa- 

 tions of I. MUNK and ROSENSTEIN 2 on human beings. 



The reason why the sugars and other soluble bodies do not pass 

 over into the chylous vessels in appreciable quantity is, according to 

 HEiDENHAiN, 3 to be found in the anatomical conditions, in the arrange- 

 ment of the capillaries close under the layer of epithelium. Ordinarily 

 these capillaries find the necessary time for the removal of the water 

 and the solids dissolved in it. But when a large quantity of liquid, 

 such as a sugar solution, is introduced into the intestine at once, this is 

 not possible, and in these cases a part of the dissolved bodies passes into 

 the chylous vessels and the thoracic duct (GINSBERG and ROHMANN 4 ). 



The passage of sugar into the urine, when at one time large quanti- 

 ties of sugar are taken and the assimilation limit is exceeded, can be 

 best explained by the assumption that a part of the sugar escaped the 

 liver and passed into the large circulation, or that the liver did not have 

 time to retain the sugar and transform it into glycogen. According to 

 the observations of de FiLiPPi 5 upon dogs with ECK fistula, it seems as if 

 the r61e of the liver in these cases is too highly estimated. An animal 

 with ECK fistula could take an unlimited quantity of starch without 

 glycosuria occurring. The assimilation limit was in these cases some- 

 what lower, but qualitatively they behave like normal animals and with 

 increasing sugar supply they could also retain increasing quantities of 

 sugar. 



The introduction of larger quantities of sugar into the intestine at 

 one time can readily cause a disturbance with diarrheal evacuations 

 of the intestine. If the carbohydrate is introduced in the form of starch, 



1 For the literature in regard to the passage of various kinds of sugars into the 

 urine, see C. Voit. Ueber die Glykogenbildung, Zeitschr. f. Biologic, 28, and F. Voit, 

 footnote 1, p. 396. See also Blumenthal, Zur Lehre von der Assimilationsgrenze 

 der Zuckerarten, Inaug.-Dissert. 1903, Strassburg and Brasch, Zeitschr. f. Biol., 50. 



2 v. Mering. Arch. f. (Anat. u). Physiol., 1877; Munk and Rosenstein, Virchow's 

 Arch. 123. 



3 Pfluger's Arch., 43, Suppl. 



4 Ginsberg, Pfluger's Arch., 44; Rohmann, ibid., 41. 



5 Zeitschr. f. Biol., 49 and 50. 



