928 METABOLISM. 



von Mering and Minkowski, 1 that complete removal of the pancreas in 

 the dog, cat, and pig, 2 is inevitably followed by a very severe form of 

 diabetes, having the usual characters of that disease in man, namely, an 

 enormous increase in the excretion of water, and the appearance in the 

 urine, besides sugar, of aceto-acetic acid, acetone, and sometimes of oxy- 

 butyric acid. That this condition is not in any way due to the abolition 

 of the secretion of the gland, was further shown by the observation that 

 it does not occur if the duct of Wirsung be tied, or if it and its branches 

 be blocked by the injection of paraffin into them, and the gland left in 

 situ, nor even if a certain proportion of the gland be left, its secretion 

 being prevented from passing into the intestine ; nor does it occur if a 

 portion of the pancreas be detached from its normal position and trans- 

 planted elsewhere, either underneath tne skin or in the peritoneal cavity, 3 

 and the remainder of the organ subsequently removed, although diabetes 

 will appear in the severest form immediately after the removal of the 

 transplanted portion from its subcutaneous situation. 



The observations of v. Mering and Minkowski have been repeated 

 and extended by Minkowski himself and by many other physiologists. 

 The removal of the organ is less difficult than might be supposed, the 

 chief precaution to take being to interfere as little as possible with the 

 supply of blood to the duodenum. The complete removal is found 

 invariably to be immediately followed by a considerable increase of 

 sugar in the blood, where the amount of sugar may reach as high as 046 

 per cent., and its consequent appearance in the urine, in which the 

 amount may rise to as much as 8 per cent, or more. In the increased 

 amount in the blood pancreatic diabetes agrees with puncture diabetes, 

 and differs from phloridzin diabetes, in which, as already stated, the 

 amount of sugar in the blood is not increased, although there is a large 

 increase of sugar in the urine. Concomitantly with this increase of 

 sugar in the blood and its consequent appearance in the urine the 

 glycogen of the liver disappears. 4 When no carbohydrate is given with 

 the food, and even during prolonged fasting, the sugar continues to be 

 eliminated in considerable quantity ; and since, under these circum- 



1 Arch.f. exper. Path. u. PharmaJcoL, Leipzig, 1889, Bd. xxvi. ; see also Minkowski, ibid., 

 1893, Bd. xxxi. S. 85. The experiments of v. Mering and Minkowski have been repeated by 

 many observers, amongst whom may be mentioned especially Dominicis (Gior. internaz. d. -sr. 

 med., Napoli, 1889), Hedon, Thiroloix, Gley, and Lepine (numerous papers during the last 

 seven years in the Compt. rend. Acad. d. sc., Paris ; and in the Compt. rend. Soc. de 

 bioL, Paris; in the Arch, de physiol. norm, et path., Paris; and Arch, de med. exptr. 

 et d'anat. path., Paris) ; Vaughan Harley, Journ. Anat. and PhysioL, London, 1891, vol. 

 xxvi. ; Journ. PhysioL, Cambridge and London, 1891, vol. xii. p. 391 ; Caparelli (Atti d. 

 Accad. Gionenia disc, nat.in Catania, 1892, tome v. ; Sandmeyer, Ztschr.f. BioL, Miinchen, 

 1893, Bd. xxix. S. 86. 



2 The results in the rabbit were somewhat doubtful, and negative results were obtained 

 in birds and in the frog. Aldehoff (Ztschr. f. BioL, Miinchen, 1892, Bd. xxviii.), however, 

 has obtained pancreatic glycosuria in the frog ; as has also Marcuse (Verhandl. d. physiol. 

 Gesellsch. zu Berlin, 1893-94, S. 98, in Arch. f. PhysioL, Leipzig), who states that it fails 

 to occur if the liver be previously removed. This is also the case, according to Langen- 

 dorff (Arch. f. PhysioL, Leipzig, 1887, S. 138), with the diabetes produced by strychnine 

 and by puncture, but not with that produced by curari. Of. , however, Rohmann, Centralbl. 



f. PhysioL, Leipzig u. Wieu, 1887, Bd. i. S. 122. 



3 Thiroloix (" Le diabete pancreatique," Paris, 1892) at first obtained a contrary result, 

 but in later experiments (Arch, de physiol. norm, et path., Paris, Oct. 1892) succeeded in 

 confirming the original statement of v. Mering and Minkowski. 



4 According to He"don (Arch, de physiol. norm, et path., Paris, 1893), the sugar in the 

 liver may nevertheless be increased in pancreatic diabetes. The administration of 

 Isevulose causes the reappearance of glycogen in the liver, although dextrose does riot 

 (Minkowski, Arch. f. exper. Path. u. PharmakoL, Leipzig, 1893, Bd. xxxi.). 



