PENTOSURIA 271 



Additional cases of pentosuria have been described by Colombini in mor- 

 phin habitues ; by Caporelli in xanthoma, others by Eeale and Romme, and a 

 case of alimentary pentosuria with glycosuria by Barszewsky. 



It is not remarkable that so many cases of pentosuria have been confounded 

 with diabetes, for the qualitative tests are the same. The important ques- 

 tion is, and remains : Has pentosuria anything in common with diabetes? Have 

 pentosurics on account of their pentosuria a special liability to become diabet- 

 ics? On account of what has been above stated these questions must be 

 answered negatively. 



Pentosuria is a disturbance of metabolism which is connected perhaps with 

 cerebrin metabolism, perhaps with the formation of galactose. Negatively the 

 principal point is that there is no evidence of insufficiency in the utilization of 

 the carbohydrates consumed with the food. 



Another question now arises : What is the prognosis of pentosuria ? It is 

 unwise to express a dogmatic opinion on this point since we have known 

 the disease for only a decade. Notwithstanding this, it may be said that the 

 prognosis is probably much more favorable than in mild diabetes, for the pen- 

 tosuric utilizes fully the starches and other carbohydrates which are adminis- 

 tered with the food, and the amount of pentose which he forms and excretes 

 is small, at most from 15 to 20 grams per day. This, therefore, represents 

 no more serious prognosis than the mildest cases of diabetes. Upon the other 

 hand it must not be forgotten that sugar is circulating in the blood. That 

 this is true is obvious from the investigations conducted by Bial and myself, 

 as we have proven the presence of arabinose in the blood. But the presence 

 of a large quantity of sugar in the blood leads to arteriosclerosis, and may 

 give rise to other changes. 



Whether the pentosuric is more susceptible to infections than a healthy 

 person, as is the case with diabetics, is very difficult to say, for up to the pres- 

 ent time the data are very scanty. Upon the whole, and in the majority of 

 cases, the prognosis of pentosuria can certainly not be termed very serious. 



Regarding therapy, such treatment as we employ in diabetes is out of place 

 in pentosuria, as is obvious from all that has been stated. In general only 

 this much is to be said: (1) A pure meat diet, according to the experience 

 of Fritz Meyer and myself, is not well borne by pentosurics, for neuralgic 

 symptoms, if present, are increased. (3) A milk diet is found to be particu- 

 larly advantageous. 



In conclusion, a word regarding the frequency of the disease. Although 

 it may be assumed from the, as yet, scant publications that pentosuria is a 

 rare aifection, I cannot admit that it is to be regarded as a curiosity like 

 maltosuria. Such a comparison is incorrect, for pentosuria, in the first place, 

 gives us a very interesting insight into disturbances of metabolism ; and sec- 

 ondly, it cannot be considered immaterial that a person, as in almost all of the 

 cases that have been cited here, should be supposed for years to be a diabetic, 

 and subjected to dietetic and mineral spring treatment which is absolutely 

 out of place. In life insurance the decision is of the greatest importance. The 

 pentosurics must at least be admitted to have as favorable a prognosis as the 

 mild cases of diabetes. 



