Auer-Kleiner Morphine Test. 



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The application of the Auer-Kleiner morphine test in human 



diabetes. 



By Albert A. Epstein. 



[From the Mt. Sinai Hospital, New York City] 



Auer-Kleiner 1 have found that the administration of morphine 

 of definite dosage to dogs, in which the pancreas had been injured 

 experimentally, caused a very marked rise in the blood sugar, 

 lasting several hours. The administration of opium and its deriva- 

 tives in the treatment of diabetes mellitus has been a common 

 practice for many years. Many noted observers ascribe beneficial 

 results to this agent. Even today opiates are commonly used in 

 diabetes, particularly in painful conditions, which often com- 

 plicate this disease. 



The observations of Auer and Kleiner are therefore of interest 

 and importance, not only from the standpoint that the administra- 

 tion of morphine to diabetic suspects might (in a very simple 

 manner) give a clue as to the existence of the disease, but they 

 would throw light also on two other phases; namely, (1) the 

 relation of glycosuria to pancreatic disorders; (2) the effect of 

 morphine on the course of the hyperglycemia in diabetes. In 

 other words, if morphine is capable of superinducing a hyper- 

 glycemia in animals with pancreatic injury, the increase of a 

 hyperglycemia after the use of morphine in a diabetic individual 

 or its development in a diabetic suspect, would indicate, on the 

 one hand, that a pancreatic disturbance is present; on the other, 

 that the beneficial effects of morphine (as regards pain, etc.) are 

 accompanied by undesirable developments. 



I have applied this test in a number of diabetics, both in the 

 sugar-free and the glycosuric states, with the object of determining 

 whether or not the results obtained in experimental animals occur 

 in the human being. The dose of morphine used, given hypo- 

 dermically, was yi of a grain (0.015 g-)- This dose is relatively 

 small compared to that used by Auer and Kleiner, in their experi- 

 ments on dogs; but it is the maximum dose that I felt justified 



1 Auer and Kleiner, Proc. Soc. Exp. Biol, and Med., XV, 1, p. 2, 1917. 



