EXPERIMENTAL DIABETES 369 



There is considerable evidence to hand that, in the earlier 

 stages of diabetes at least, processes of oxidation proceed in their 

 normal fashion in the organism : benzol is oxidised to phenol ; fat 

 is oxidised to carbonic acid and water ; organic acids are oxidised 

 to carbonates. Conversely, we can experimentally diminish oxida- 

 tion in the organism for example, by poisoning with phosphorus 

 without inducing any glycosuria. Deficient oxidation is therefore 

 not the immediate cause of diabetes. 



It is much more probable that a want of disruption of the 

 dextrose molecule is the primary cause of its non-utilisation by 

 the organism, and it is commonly assumed further that the dis- 

 ruptive process is an antecedent of the oxidative : that oxidation 

 is only possible after the large sugar molecule has been broken 

 into smaller groups. 



In the severer forms of the disease, however, the oxidative 

 processes are also depressed, for incompletely oxidised bodies make 

 their appearance in the urine, such as /3-oxy-butyric acid, acetone, 

 and aceto-acetic acid, and the intake of oxygen becomes much 

 less than in health, whereas it might be expected to be more, 

 on account of its having to oxidise proteid and fat which require 

 relatively more oxygen for their oxidation than carbohydrates 

 do instead of dextrose, which cannot be utilised by the 

 organism. 



Being deprived of the power of utilising dextrose, the dia- 

 betic organism, in order to obtain the energy necessary for life, 

 is compelled to live on fat and proteid. Sufficient of these 

 food-stuffs is frequently not absorbed from the intestine (especi- 

 ally where, as is common enough, absorption is interfered with), 

 so that the tissue fat and proteid are used up, and emaciation 

 results. 



Death may result from this, for soon all the available proteid 

 and fat become exhausted, and the organism, incapable of oxidising 

 carbohydrates, does not obtain the energy necessary to carry on its 

 vital functions. Death, in such cases, is really due to acute starva- 

 tion. Quite frequently, however, in Diabetes mellitus death is due 

 to another cause than acute starvation, namely, to diabetic coma. 

 This can best be described as a condition of gradually increasing 

 collapse and mental dulness, frequently associated with a form of 

 dyspnoea " air hunger " in which the respiratory movements 



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