106 ACIDOSIS, ACETONJffiMIA, 



positively in need of sugar. It is probably the main 

 source of muscular energy. A beating mammalian 

 heart, through which a solution of salines containing 

 sugar is repeatedly passed, will use up that sugar. 

 It is a principal source of heat. It is probably a 

 necessity for nearly all the functions of the proto- 

 plasm of the tissues. The blood always contains 

 sugar (about o-i per cent) to supply this need ; the 

 whole process of glycogen storing in the liver is 

 designed to keep the percentage at a constant level 

 in the blood. The internal secretion of the pancreas 

 is the link 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 0-3 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 utilized. 

 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 wastefully to obtain a sugar which, 

 though obtained, can never be used. So we see the 

 pktient losing flesh, and 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 



