100 



PRODUCTS, ADVENTITIOUS. 



ingesta and digesta of diabetic patients, con- 

 tinued in two cases daily without interruption 

 for several months, and for a few days at a 

 time in several other cases, are as follows: 



" The quantity of saccharine matter found in 

 the urine never exceeded the sugar and starch 

 in the food. On the other hand, the sugar and 

 starch of the food were accounted for in the 

 urine to within one-fourth or one-fifth of the 

 whole quantity. As there was always sugar 

 besides in the fa?ces in a sensible, although not 

 considerable, quantity, it appeared to follow 

 that sugar and substances convertible in the 

 stomach into sugar, are, in diabetic patients, 

 nearly if not entirely indigestible ; that is, they 

 pass through the blood without being burned 

 and thrown off in the form of carbonic acid 

 and water, as they are in a healthy state. The 

 idea of any portion of the saccharine matter 

 found in the urine being formed from the pro- 

 tein or azotized portion of the food was 

 entirely excluded. 



" The proportion of sugar in the urine has a 

 limit which it cannot exceed, but which varies 

 within a small range in different patients, about 

 4^ per cent, being the usual maximum. The 

 volume of the urine comes, therefore, to be en- 

 tirely governed by the quantity of saccharine 

 matter in the food. 



" Although sugar escapes oxidation in the 

 respiratory process of diabetic patients, alcohol 

 is entirely consumed. On one occasion a dia- 

 betic patient swallowed twelve ounces of abso- 

 lute alcohol, contained .in a quart of whisky, 

 within twenty-four hours, without a trace of it 

 appearing in his urine or other excretions. 

 Gum arabic also, taken as food to the extent of 

 five or six ounces a-day, did not cause an in- 

 crease of sugar in the urine, and was probably, 

 therefore, digested. Both alcohol and gum are, 

 like sugar, pure aliments of respiration. 



" It is well known that in the air expired by 

 man, the proportion between the volume of 

 carbonic acid found and oxygen deficient is 

 remarkably uniform, and indicates that an 

 excess of oxygen, nearly constant in amount, 

 is consumed above what is represented by the 

 carbonic acid, due of course chiefly to the 

 oxidation of hydrogen. An amylaceous diet, in 

 which the only combustible element is carbon, 

 tends to reduce this disproportion, while an 

 animal diet increases it. I therefore expected 

 to find a deficient proportion of carbonic acid 

 in the expired air of a diabetic patient confined 

 to an animal diet ; but such was not the case ; 

 the proportion proved to be perfectly normal. 

 This implies a considerable waste of azotized 

 food, that even the protein-compounds are 

 only partially digested in the system of a 

 diabetic patient. The assimilating power ap- 

 pears, indeed, to be generally deficient." 



According to Mr. Graham, then, the disease 

 is to be understood thus : In consequence of 

 deficient oxidation of sugar in the respiration- 

 process, that substance (which in the natural 

 state of things is burned off as quickly almost 

 as it mixes with the circulating fluid) accumu- 

 lates to a greater or less extent in the blood, 

 and its elimination from this fluid is partially 



effected through the secretions, especially the 

 urine. This is a most plausible and clear view 

 of the chemical mechanism of sugar disease ; 

 but a quid ignotum the cause of the deficient 

 oxidizing power remains in the back-ground, 

 mysterious and unpenetrable. 



CLASS II. PLASTIC PRODUCTS. 



This class includes all products possessed of 

 organized arrangement, whether their structure 

 be of a rudimentary or advanced kind; we 

 shall distinguish them by the term FORMATIONS. 

 Formations are themselves separable into two 

 very distinct sub-classes; the one in which 

 the formation depends for continued existence 

 upon the immediate and direct access of nutri- 

 tious matter from the blood of the parent or- 

 ganism (Blastemal Formations'] ; the other in 

 which the vitality of the formation is not 

 dependent upon such direct access (Germ- 

 Formations or Parasites], While the products 

 referrible to these two sub-classes differ in 

 their structural characters, in their properties, 

 in their vital actions, and in their influence 

 on the organism containing them, they are no 

 less distinct in their mode of origin. Those 

 belonging to the one sub-class originate in a 

 structureless fluid or blastema ; those belonging 

 to the other spring from a germ. And the 

 distinctive attributes of the two sub-classes may 

 in the most concise manner be put thus: 



Sub-Class I. Dependent existence ; origin 

 from a blastema. 



Sub-Class II. Independent existence ; 

 origin from a germ. 



SUB-CLASS I. BLASTEMAL FORMATIONS. 



The structureless fluid just referred to is 

 termed blastema (from fihao-Tog, a germ) in 

 consequence of its being the germinal material 

 from which certain formations are evolved ; 

 and likewise cytoUastcma (KVTOS, a cell), be- 

 cause an essential process in that evolution is 

 the generation of cells. 



The source of this material, as of the forma- 

 tive material of the natural elements of the 

 organism is none other than the circulating 

 fluid the blood.* But there are three possible 

 forms in which the blood ma} r be supposed to 

 furnish the germinal material in question. First, 

 the blood in substance may itself constitute 

 blastema ; secondly, some of the elements of 

 the blood, unaltered in properties, may con- 

 stitute blastema ; and, thirdly, some of those 

 elements altered in properties may constitute 

 blastema. 



Now, analogy is opposed to the admission 

 of the first of these possible cases : there is no 

 instance of a natural structure being evolved 

 from the blood as a whole. But arguments 

 founded on analogy are valueless, if at variance 

 with the results of direct and satisfactory 

 observation. As matter of experience, then, 

 does blood in substance, unaltered in apparent 

 physical properties, and either retained within 



* Of the chyle and lymph, as suppliers of blaste- 

 ma! elements, nothing is known practically. 



