AND DIABETES 167 



in the blood. The internal secretion of the pancreas 

 is the Hnk whereby the tissues may take hold of and 

 utilize this circulating sugar. In diabetes the internal 

 secretion of the pancreas fails, and the link is missing. 

 The tissues are in the position of the hungry boy 

 outside the sweet-shop ; he longs for the sweets and 

 the supply is abundant, but he has not the means to 

 purchase. So the sugar in the blood, lacking a 

 market, goes on accumulating till it reaches a figure 

 of 0'2 or 03 per cent ; it runs to waste in the urine, 

 but the tissues cannot touch it. Like a starving town 

 through which rich convoys are passing, the plenty 

 comes to their very doors, but cannot be utihzed. 

 Urgent messages for food are sent to the liver, to other 

 organs, to the intestine ; these are depleted of all their 

 reserves of glycogen, and even the proteins themselves 

 are broken down wastefuUy to obtain sugar, some of 

 which slips out into the blood and is permanently 

 lost to the tissues. So we see the patient losing 

 flesh, a.nd not only sugar but also excess of urea 

 appear in the urine, derived of course from the 

 proteins. 



Naturally, in most cases matters have not progressed 

 quite so far ; a little of the pancreatic secretion con- 

 tinues to be supphed, and if carefully husbanded, 

 as by reducing the carbohydrate in the food, may 

 suffice for the bare needs of the body. To return to 

 the illustration, the hungry boy is not quite penniless, 

 and if he spends his money wisely he may yet keep 

 himself going by alternating periods of self-denial 

 and mild indulgence. 



It must be admitted that some researches of the 



