DIABETES MELLITUS. 313 



for the production of the ferment through the action of which small 

 quantities of sugar are continually formed in the liver. As the liver is 

 thus the seat for the production of sugar, extirpation of this organ or 

 ligation of its vessels is followed by disappearance of the sugar con- 

 tained in the blood. 



The grape-sugar formed in the liver is destroyed in part in the blood- 

 stream, on its way through the tissues, in part by a special ferment, 

 which appears to be derived principally from the pancreas, and to be 

 carried by the blood-corpuscles. A portion of the sugar in the blood is 

 converted in the muscles into glycogen. 



According to Kiilz and Vogel, the same process takes place in the liver in 

 the formation of sugar from glycogen as results from the action of the saliva and 

 the pancreatic juice, with the production likewise of maltose and isomaltose. 

 According to E. Cavazzani, irritation of the celiac plexus causes the production 

 of sugar in the liver, in connection with which the liver-cells undergo morphologic 

 change. 



Further, /a/5 are observed in the liver-cells, in the form of granules, as 

 well as free in the bile-ducts ; occasionally when the diet is rich in fat (in 

 greater amount in drunkards and tuberculous patients), olein, pal- 

 mitin, stearin and volatile fatty acids are found. Further, sarcolactic acid, 

 traces of cholesterin, jecorin, finally small amounts of urea (in increasing 

 amount in the warm, "surviving" liver), uric acid; and leucin, ty rosin 

 (guanin?), sarcin, xanthin, and cystin pathologically in conjunction with 

 putrefactive disorders, may be present. 



The liver-cells contain pigments, which are partly soluble in feebly 

 alkaline water, partly in chloroform. 



The pigment soluble in water, designated ferrin, varies from yellow to red in 

 color and contains almost all o the iron of the liver. The latter can be demonstrated 

 directly by means of potassium ferrocyanid or ammonium sulphid. The pigment 

 soluble in chloroform, designated chofechrome, can be extracted from pulverized 

 dried liver. It stands midway between bile-pigment and the lipochromes. 



The inorganic constituents of the liver are potassium, sodium, calcium, 

 magnesium and manganese. Iron in organic combination with albumin 

 (in ferratin) is present in the liver to the amount of about 6 per cent. 

 Abstraction of blood together with albumin-hunger causes its disappear- 

 ance. It is utilized in the production of new blood. Chlorin, phosphoric, 

 sulphuric, carbonic and silicic acids may also be present ; and copper, zinc, 

 lead, mercury and arsenic have been found deposited in the liver acci- 

 dentally. 



DIABETES MELLITUS. 



The formation of large amounts of grape-sugar by the liver and their entrance 

 into the blood and into the urine (glycosuria, diabetes melhtus) have been brought 

 into relation with the normal conditions already mentioned. Extirpation of the 

 liver in. the frog or destruction of the liver-cells (fatty degeneration from phos 

 phorous or arsenical poisoning) does not cause the appearance of this phenomenon. 

 It occurs a few hours after injury to a particular spot (center for the vasomotor 

 nerves of the liver) on the floor of the lower portion of the fourth ventricle 

 Bernard's sugar-puncture, piqure) ; further, after division of the vasomot 

 paths in the^ spinal cord from above downward to the exi 

 for the liver that is to the lumbar portion, in the frog to the fourth vertebra. 



Division or paralvsis of the vasomotor conducting paths from the ceni 

 the liver results in glvcosuria. According to recent researches 1 >y I- ranjois I- ranck 

 and Hallion, the vasomotor nerves of the liver (for the hepatic artery anc 

 portal vein) arise between the sixth dorsal and the second lumbar nerves am 



