AND DIABETES is9 



result of a peculiar abnormal process of breaking 

 down of the fats. 



The physiological process of dealing with fat is to 

 resolve it into carbon dioxide and water. If we 

 make a pound of fat into tallow candles and burn it, 

 we shall obtain carbon dioxide and water, and a 

 certain amount of heat will be evolved. If the pound 

 of fat is eaten and absorbed by a man or an animal, it 

 will be burnt to the same end-products, and the same 

 amount of heat will be given out. But in certain 

 circumstances, an abnormal mode of breaking down 

 is followed, and there are produced first /3-oxybutyric 

 acid, then diacetic acid, and finally acetone. If this 

 takes place on a large scale, the conversion into 

 acetone fails to keep pace with the production of the 

 acids. Therefore first acetone appears in the urine, 

 then diacetic acid, and finally /3-oxybutyric acid ; 

 the last may rise rapidly to an enormous figure : 30, 

 50, or even 180 grams may be passed daily in dia- 

 betic- coma (Magnus Levy). 



Feeding on fats will always cause some rise in the 

 output of acetone and of these acids if they are already 

 present ; in starvation it will cause a very marked 

 increase. Butter, which contains lower fatty acids 

 (butyric, etc.) , as well as fats, is particularly active in 

 this respect. 



It is of no great importance to us to know where 

 in the body this process of breaking down takes place ; 

 the liver is usually supposed to have the power to 

 effect it. 



We next ask, What are the special circumstances 

 in which the breaking down of fat deviates from 



