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Scientific Proceedings (34). 



diets were used and the urine was analyzed over a period of more 

 than three months. A portion of the results of the last part of 

 the period is given in the accompanying table. The unusual fea- 

 tures of these results will be briefly discussed. 



Between twenty and eighty grams of total /9-oxybutyric acid 

 (the acetone and diacetic acid being calculated as /3-oxybutyric 

 acid) were excreted each day for at least eighty days without any 

 signs of impending coma. For more than two months with this 

 severe acidosis the subject showed practically complete carbo- 

 hydrate intolerance. As shown in the table the diet was then 

 changed to 255 grams of oatmeal. On this diet the acidosis and 

 the glycosuria decreased very much, the former ultimately disap- 

 pearing. This comparatively sudden transition from a condition of 

 severe to one of mild diabetes is very striking and appears to con- 

 firm the good results obtained by von Noorden and others with his 

 so-called "oat cure." 



The dependence of /3-oxybutyric acid production upon the 

 amount of fat in the food was very clearly shown throughout the 

 observations. The amount of total /3-oxybutyric acid excreted 

 varied in general with the amount of fat eaten, which is not usually 

 the case. Note the effect of the addition of butter to the oatmeal 

 diet. The amount of food-fat appears to have determined, in this 

 instance, the amount of fat burned. 



An increase in the amount of fat in the food which caused an 

 increased acidosis appeared to result also in a damage to the 

 carbohydrate tolerance ; with the increase of acidosis there was a 

 very marked decrease in the amount of sugar burned. This phe- 

 nomenon is just the reverse of that so often observed, i. e., the 

 decrease of acidosis with an increased burning of sugar, and again 

 emphasizes the close inter-dependence between the metabolism of 

 carbohydrate and fat. 



The observations were terminated by the death of the patient. 

 The immediate cause of death was not definitely established but 

 was probably due to the phthisis which complicated the diabetes. 

 There was no sign of coma and in view of the absence of acidosis 

 and of the great improvement in carbohydrate tolerance we can 

 scarcely believe that the diabetes was immediately responsible. 

 The blood obtained at autopsy contained only traces of /3-oxybutyric 

 acid, the whole blood containing about 0.3 gram. There was no 



