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406 THE LIVER.
the liver loses weight more than the other parts of the body. Pfluger
concludes from this that the liver in diabetes works actively, and is the
most important seat of production of diabetic sugar.
Pfluger has found that in frogs the total extirpation of the duodenum
causes a strong and continuous glycosuria and based upon his investigations
and those of other investigators, he believes that a certain relation exists between
the duodenum and pancreas diabetes. The question as to the occurrence of a
duodenal diabetes has been the subject of numerous investigations but the works
-of Ehrmann, Minkowski and Rosenberg x
show that such a view is untenable.
There does not seem to be any doubt as to the existence of a certain
relationship between the pancreas to the adrenals and adrenalin gly-
cosuria. The glycosuric action of adrenalin could be prevented by
Zuelzer by the injection of pancreas extracts, and this statement is
confirmed by Frugoni by experiments with pancreatic juice or pancreatic
extracts, v. Furth and Schwarz 2
have confirmed the correctness of
.Zuelzer’s statement but dispute the fact that we are here dealing with
an antagonistic hormone action as they have obtained similar results also
with other bodies, for example with turpentine.
Very stimulating views on the relationship of pancreas diabetes
to the adrenals and the thyroids have been given by. Falta, Eppinger
and Rudinger.3 According to these investigators a reciprocal retarda-
tion exists between the pancreas and thyroid as between the pancreas
and the adrenals while a mutual accelerating action exists between the
thyroids and the adrenals. Tn depancreatized dogs the retarding action
of the pancreas upon the thyroids is removed, and in this way we explain
the strong increase in the protein, fat (Mohr) and salt-metabolism
(Falta and Whitney 4
) observed in pancreas diabetes. By the removal
of the retarding action of the pancreas upon the adrenals, the mobiliza-
tion of the carbohydrates by means of the adrenalin is increased, and
herein, as well as the diminished sugar utilization, lies the reason for the
strong elimination of sugar. The relations between the above three
glands is still further described by the above-mentioned authors, but we
cannot enter more into detail in regard to the interesting question,
which requires further study.
The conditions in pancreas diabetes are certainly very complicated,
and the reasons for this are still very uncertain. Most investigators are of
1
Rosenberg, Bioch. Zeitschr., 18, which contains the literature.
2
Frugoni, Berl. klin. Wochenschr., 45, 1908; v. Furth and Schwarz, Bioch. Zeitschr.,
31.
3
Eppinger, Falta and Rudinger, Zeitschr. f. klin. Med., 66, which also contains the
literature on adrenalin diabetes.
4
Mohr, Zeitschr. f. exp. Path. u. Therap., 4; Falta and Whitney, Hofmeister’s
Beitrage, 11.
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