6G 



liver, but in liealtli the resulting sugar is burneu up m the circula- 

 tion and does not apx3ear in the urine. On the contrary, when the 

 sui^ply of oxygen is defective, as in certain diseases of the lungs, the 

 whole of the sugar does not undergo combustion and the excess is 

 excreted by the kidneys. Also in certain forms of enlarged liver 

 the amount of sugar x^roduced is more than can l>e disj^osed of in the 

 natural way, and it appears in tlie urine. A temporary sweetness of 

 the urine often occurs after a hearty meal on starchy food, but this 

 is due altogether to the su]oerabundant sux)ply of the sugar-forming 

 food, lasts for a few hours only, and has no ^pathological significance. 

 In many cases of fatal glycosuria the liver is found to be enlarged, or 

 at least congested, and it is found that the disorder can be produced 

 experimentally by agencies which j)roduce an increased circulation 

 through the liver. Thus Bernard produced glycosuria by pricking 

 the oblong medulla at the base of the brain close to the roots of the 

 pneumogastric nerve, which happens to be also the nerve center 

 (vaso-motor) which presides over the contractions of the minute blood- 

 vessels. The x)ricking and irritation of this center leads to congestion 

 of the liver and the excessive production of sugar. Irritation carried 

 to this point through the pneumogastric nerve causes saccharine 

 urine, and, in keeping with this, disease of the pancreas has been 

 found in this malady, the irritation being conveyed thence to the brain 

 through the i)neumogastric nerve and reflected to the liver through 

 the vaso-motor nerves. The same result follows the reflection of irri- 

 tation from other sources, as from different ganglia (corpora striata, 

 optic tlialami, x>ons, cerebellum, cerebrum) of the brain. Similarly 

 it is induced by interruption of the nervous control along the A'aso- 

 motor tracts, as in destruction of the upper or lower cervical sym- 

 pathetic ganglion, by cutting the nervous branch connecting these 

 two, in injury to the spinal marrow in the interval between the brain 

 and the second or fourth dorsal vertebra, or in disease of the coeliac 

 plexus, which direclt}^ iDresides over the liver. Certain chemical poi- 

 sons also cause saccharine urine, notably woorara, strychnia, morphia, 

 phosphoric acid, alcohol, ether, chloroform, quinia, ammonia, and 

 arsenic. 



The sympfoms are ardent thirst and profuse secretion of a pale urine 

 of a high density (LOGO and upward), rapid loss of condition, scurfy, 

 unthrifty skin, costiveness or irregularity of the bowels, indigestion, 

 and the presence in the urine of a sweet principle, grape-sugar or ino- 

 site, or both. This maj^ be most i^romptly detected by touching the 

 tip of the tongue with a drop. Sugar may be detected simply by 

 adding a teaspoonf ul of liquid yeast to 4 ounces of the urine and keep- 

 ing it lightly stopped at a temperature of 70° to 80° F., for twelve 

 hours, whe)i the sugar will be found to have been changed into alco- 

 hol and carbon dioxide. The loss of density will give indication of 

 the amount of sugar transformed; thus a density of 1,035 in a urine 



