50 INTERNAL SECRETION 



ereatized dog is said to be greater and more frequent than in 

 human subjects with diabetes. The changes found in the 

 islets of Langerhans in human diabetes are not so striking as 

 in dogs after removal of large portions of the pancreas. Finally, 

 dogs with experimental diabetes rarely die of coma, while 

 this is notoriously a common ending in the case of human 

 beings with diabetes. Allen, who has carried out a great 

 amount of painstaking work on this subject, points out that 

 dogs have much less tendency to ketonuria than man, and 

 believes that experiments upon animals of other species may 

 give a result more nearly approaching human diabetes. He 

 is inclined to believe that explanations may be found for the 

 other differences enumerated. 



Nothing is certainly known about the nature and origin of the 

 acidosis and the diabetic intoxication which gives rise to coma. 

 It is generally believed, however, that ketones are formed as 

 a result of an incomplete destruction of fat, due to an imperfect 

 consumption of carbohydrates. The ketones become oxidized 

 to acetoacetic and /? oxybutyric acids. The condition is 

 often referred to as ketosis. The intoxication seems largely 

 due to the increased acidity, an increased H ion concen- 

 tration, 



After extirpation of the pancreas in dogs and cats, Loewi 

 produced dilatation of the pupil by the installation of adrenin. 

 He attributes the dilatation to an increased excitability of 

 the sympathetic nervous system. The reaction has been used 

 as a test for pancreatic deficiency in the human subject, but 

 does not appear to be very reliable. 



Organotherapy treatment with pancreas or extracts made 

 from it appears to be useless. The most modern form of 

 treatment and, so far as can be judged from the clinical 

 evidence available, the most successful form, is by fasting, 

 combined with vigorous exercise. These measures, at any 

 rate, prolong the life of the patient and render him useful 

 and comfortable, even if they do not cure. As Allen points 

 out, what is required is some means of strengthening the 

 weakened function as well as giving it a rest. There can, 

 however, be little hope for this till we are quite clear about 

 the pathogenesis of the condition. 



A functional relationship between the islets of Langerhans 

 and the reproductive organs is claimed by some observers 



