104 



Mr. E. Mellanby. 



[Oct. 3, 



glucose feeding — was the creatin excretion abnormally low, and indeed in 

 the former case the creatin ratio was high. 



Another point worthy of comment is the very poor progress of the baby 

 whose mother took glucose. Of all the cases investigated this baby did the 

 worst.* This may have been a coincidence, but there is some evidence that 

 the glucose solution itself had a detrimental effect, in that when it was 

 substituted for lactose in the first case described, this baby's weight began 

 to diminish, although previously it had developed remarkably well. On the 

 two glucose-feeding days it lost 1\ oz. in weight, whereas in the previous 

 two lactose-feeding days, the weight of the baby increased 3£ oz. 



Whether or no glucose feeding to a puerperal mother has a detrimental 

 effect in all cases on the development of an adequate mammary gland 

 secretion, the above results quite suffice to demonstrate that the creatin 

 excretion of the puerperium is of a different nature from that excreted 

 during periods of inanition or when carbohydrate is withheld from the diet. 



In view of the great amount of attention the relation of creatin to 

 carbohydrate metabolism has in recent years attracted, it may be well to 

 consider briefly this subject with reference to the results obtained in this 

 section. It is generally admitted that if carbohydrate metabolism be 

 abnormal in mammalia, then creatin is excreted. For instance, it has been 

 shown that the creatin excretion produced by inanition can be cleared up by 

 the ingestion of carbohydrate (Cathcart (7), Mendel and Eose (8) ). Further, 

 the absence of carbohydrate from an otherwise normal diet results in the 

 excretion of creatin. Also in diabetes mellitus and phloridzin glycosuria 

 (Krause and Cramer (9), Cathcart and Taylor (10) ) creatin is excreted. It is 

 natural that such facts have led many physiologists to assign the most 

 intimate relationship between creatin and carbohydrate. For instance, it has 

 been suggested that creatin forms compounds with carbohydrate in the liver, 

 and is transported in such a combination to the muscles. Mendel and 

 Eose (8) have stated that, " without question, the metabolism of creatin is 

 intimately related with carbohydrate metabolism." Now it would appear 

 that all the conditions studied in this connection, either pathological or the 

 result of treatment, have one factor in common, namely, the carbohydrate 

 metabolism is either known to be or is rendered abnormal, and then the 

 creatin excretion is studied. But I venture to suggest that this is not 

 sufficient to establish a direct relation between creatin and carbohydrate. 

 If, as the result of recent metabolic research, one point has become more 



* The baby of the glucose-fed mother lost ground so rapidly that artificial feeding was 

 added after the third day, but in spite of this the baby gained no weight so long as the 

 investigation lasted. 



