90 



Scientific Proceedings (90). 



in administering to patients. The other conditions of the test 

 were like those observed by Auer and Kleiner. The tests were 

 conducted in the following manner: The patients were kept in 

 bed, and after a night of rest and fasting were given a cup of black 

 coffee early in the morning; no other food was given. At noon a 

 specimen of the patient's blood was taken for blood sugar analysis; 

 another at 12.30; a third, at one o'clock; and two others, at hourly 

 intervals. This constituted the control day, as no morphine was 

 given. At the end of this period, the patient received food. 

 On the following day, the tests were made in exactly the same 

 order, with the addition that directly after the removal of the 

 first specimen of blood, a dose of mrophine was given. The accom- 

 panying chart shows the maximum and minimum effects produced 

 by the morphine. It is evident that in the case showing the 

 maximum change (Example 1) a certain elevation of the blood 

 sugar occurs. This elevation, however, is very slight, compared 

 to the changes observed by Auer and Kleiner in dogs. The rise 

 here observed would not be sufficient to base the conclusion that a 

 mobilization of sugar occurred in consequence of the morphine 

 administration. In a majority of the cases observed, the change 

 in the hyperglycemia was even less marked than this. The other 

 case presented (Example 2) shows the course of the hyperglycemia 

 before and after the administration of the morphine. In this 

 instance, as in many others, the morphine is without any effect 

 at all. 



The results of the observations which I present here do not 

 in any way militate against the results obtained by Auer and 

 Kleiner in their experiments. The discrepancy may be due to a 

 difference in the size of the dose (per kilogram body weight) of 

 morphine used in the tests made by Auer and Kleiner, and those 

 made by me. It is questionable whether the method can have 

 the clinical application which was expected, unless one desires to 

 exceed the rules of therapeutic usage, in regard to the morphine. 

 The effect of the morphine upon all the patients tested was 

 pronouncedly narcotic. 



I have intentionally omitted to discuss the question of the 

 effect of morphine on the glycosuria because the results were too 

 variable to admit of any conclusions. 



