458 Urinary Disturbances. 



lieved that these special structures secrete and give into the blood 

 of the pancreatic vein a substance which is either itself a glycolytic 

 ferment or which is not a ferment, but a more simple substance 

 acting to energise a glycolytic ferment in the muscles and other 

 tissues of the body. This glycolytic ferment is regarded as es- 

 sential to the final transformations and chemical decomposition 

 of the sugar in the system in order that it may be assimilated: 

 in its absence assimilation ' is impossible and the body suffer.^ 

 by its inability to make use of the carbohydrates furnished to it, 

 and at the same time the sugar in the blood accunmlates and 

 when in excess (above 0.4 per cent.) is excreted in the urine.] 



In its chronic form diabetes, an expression of metabolic fault 

 and at times accompanied by fauhs of the liver and pancreas, 

 causes more or less harm to the whole body. When the incom- 

 plete assimilation of carbohydrates is not compensated by the 

 supply of albuminates and fat, especially when the associated 

 diseases do not permit the assimilation of these last named sub- 

 stances, the general nutrition must of necessity fail. In serious 

 cases there is apt to be present, as well, a marked proteid disin- 

 tegration, and albuminuria appears as a symptom, together with 

 degeneration of the lens and retina, disease of the blood vessel 

 walls and a weakened resistive state of the tissues, which induces 

 s. special predisposition to tuberculosis and gangrene (in man). 



Disturbances of micturition include difficult micturition 

 (dysiiria) caused by strictures and obstructions to the pnth of 

 outflow (the dribbling forced passage, with tenesmus and frequent 

 call to urinate, is called strangury) ; complete repression of mictu- 

 rition ( ischuria, retention of urine), in which case the bladder is 

 full because of spasm of the sphincter or paralysis of the detrusor 

 musculature; and inability to retain the urine (enuresis, incon- 

 tinentia urincr). due to a paralysis of the sphincter of the bladder 

 developing in disease of the spinal cord and of the bladder itself. 



(For details cf. Friedberger-Frohner, Klinische Untersuchungsmetho- 

 dcn.) 



Diseases of the urinary apparatus are more or less painful ; 

 affections of the passages being particularly apt to cause intense 

 pains, to be attributed in part to muscle spasms, partly to me- 

 chanical irritation (foreign bodies) of the sensory filaments of 

 the mucous membrane or to specially induced irritability (ulcers, 

 abrasions, inflammations) of these filaments. 



