364 THE METABOLISM OF THE CARBOHYDRATES 



combined ; some of it is almost certainly in a free state. What 

 the proportion between the free and combined sugar may be is as 

 yet an entirely unsolved question. 



The proteid thus deprived of its sugar in phloridzin poisoning, 

 becomes recombined with more of it during its circulation through 

 the rest of the body. When, however, the animal is starved, and 

 no fresh supply of carbohydrate is available for the reconstruction 

 of this gluco-proteid, then the poisoned kidney cells attack the 

 proteid molecule itself, and thereby liberate not only the sugar 

 which is intimately bound up in it or which is derivable from 

 certain of its decomposition products, but also the nitrogen. That 

 excessive break-down of proteids does occur in advanced phloridzin 

 poisoning during starvation is further proven by the fact that 

 /2-oxy-butyric acid, &c. 3 make their appearance in the urine. 



Adrenalin Glycoscuria. The subcutaneous or intraperitoneal 

 injection of suprarenal extract or adrenalin chloride solution causes 

 glycosuria. An examination of the blood has shown that hyper- 

 glycsemia is the immediate cause of the glycosuria, so that in- 

 creased production of dextrose in the organism, or its diminished 

 destruction, must exist. 



Starved dogs, from whose tissues most of the glycogen has 

 been caused to disappear by repeated phloridzin administration, 

 also react to suprarenal extract, so that increased production of 

 dextrose cannot be the cause of the hyperglycaemia. This does 

 not of course mean that the extent of the glycosuria induced by 

 the injection is the same in starved as in well-fed animals ; for 

 the more glycogen there is available to convert into dextrose, the 

 more marked will be the glycosuria. Diminished destruction of 

 dextrose must therefore exist. Now, we have seen that the 

 form of experimental diabetes which best typifies glycosuria due 

 to want of dextrose destruction in the tissues, is that which 

 follows extirpation of the pancreas. Can it be, then, that supra- 

 renal extract acts on this gland in some way so as to diminish 

 the influence of the latter on dextrose destruction ? Herter ( 32 ) 

 and his co-workers have shown that painting the pancreas with 

 adrenalin chloride solution likewise induces glycosuria, so that 

 the question would appear to be answered in the affirmative. 



The best known physiological action of suprarenal extract is 

 vaso- constricting. It might be thought that this is, indirectly, 

 the cause of the hyperglycsemia. That such is not the cause 



