9 2 8 METABOLISM. 
von Mering and Minkowski, 1 that complete removal of the pancreas in 
the clog, cat, and pig, 2 is inevitably followed by a very severe form of 
diabetes, having the usual characters of that disease in man, namely, an 
enormous increase in the excretion of water, and the appearance in the 
urine, besides sugar, of aceto-acetic acid, acetone, and sometimes of oxy- 
butyria acid. That this condition is not in any way due to the abolition 
of the secretion of the gland, was further shown by the observation that 
it does not occur if the duct of Wirsung be tied, or if it and its branches 
be blocked by the injection of paraffin into them, and the gland left in 
situ, nor even if a certain proportion of the gland be left, its secretion 
being prevented from passing into the intestine ; nor does it occur if a 
portion of the pancreas be detached from its normal position and trans- 
planted elsewhere, either underneath the skin or in the peritoneal cavity, 3 
and the remainder of the organ subsequently removed, although diabetes 
will appear in the severest form immediately after the removal of the 
transplanted portion from its subcutaneous situation. 
The observations of v. Mering and Minkowski have been repeated 
and extended by Minkowski himself and by many other physiologists. 
The removal of the organ is less difficult than might be supposed, the 
chief precaution to take being to interfere as little as possible with the 
supply of blood to the duodenum. The complete removal is found 
invariably to be immediately followed by a considerable increase of 
sugar in the blood, where the amount of sugar may reach as high as 0'-±6 
per cent., and its consequent appearance in the urine, in which the 
amount may rise to as much as 8 per cent, or more. In the increased 
amount in the blood pancreatic diabetes agrees with puncture diabetes, 
and differs from phloridzin diabetes, in which, as already stated, the 
amount of sugar in the blood is not increased, although there is a large 
increase of sugar in the urine. Concomitantly with this increase of 
sugar in the blood and its consequent appearance in the urine the 
glycogen of the liver disappears. 4 When no carbohydrate is given with 
the food, and even during prolonged fasting, the sugar continues to be 
eliminated in considerable quantity : and since, under these circurn- 
1 Arch./, exper. Path. u. Plmrmalcol., Leipzig, 1S89, Bd. xxvi. ; see also Minkowski, ibid., 
1S93, Bd. xxxi. S. 85. The experiments of v. Mering and Minkowski have been repeated by 
many observers, amongst whom may be mentioned especially Dominicis (Gior. interna?., d. as. 
mcd., Napoli, 1889), Hedon, Thiroloix, Gley, and Lepine (numerous papers during the last 
seven years in the Compt. rend. Acid. d. sc, Paris; and in the Corrupt, rend. Soc. de 
biol., Paris; in the Arch, de physiol. norm, et p<>th., Paris; and Arch, de med. exper. 
et d'anat. path., Paris); Vaughan Harley, Journ. Anat. and Physiol., London, 1891, vol. 
xxvi. ; Journ. Physiol., Cambridge and London, 1891, vol. xii. p. 391 ; Caparelli (Atti d. 
Accad. Gionenia disc. nat. in Catania, 1892, tome v.; Sandmeyer, Ztschr.f. Biol., Miinchen, 
1893, Bd. xxix. S. 86. 
2 The results in the rabbit were somewhat doubtful, and negative results were obtained 
in birds and in the frog. Aldehoff {Ztschr. f. Biol., Miinchen, 1892, Bd. xxviii.), however, 
has obtained pancreatic glycosuria in the frog ; as has also Marcuse (Vcrhandl. d. physiol. 
Gescllsch. za Berlin, 1S93-94, S. 98, in Arch. f. Physiol., Leipzig), who states that it fails 
to occur if the liver be previously removed. This is also the case, according to Langen- 
dorff (Arch. f. Physiol., Leipzig, 1887, S. 138), with the diabetes produced by strychnine 
and by puncture, but not with that produced by curari. Of., however, Rbhmann, Centralbl. 
f. Physiol, Leipzig u. Wien, 1S87, Bd. i. S. 122. 
3 Thiroloix (" Le diabete panereatique," Paris, 1892) at first obtained a contrary result, 
but in later experiments (Arch, de 2^hysiol. norm, et path., Paris, Oct. 1892) succeeded in 
confirming the original statement of v. Mering and Minkowski. 
4 According to Hedon (Arch, de physiol. norm, et path., Paris, 1893), the sugar in the 
liver may nevertheless be increased in pancreatic diabetes. The administration of 
lsevulose causes the reappearance of glycogen in the liver, although dextrose does not 
(Minkowski, Arch. f. exper. Path. u. Pharmakol., Leipzig, 1893, Bd. xxxi.). 
