Full resolution (JPEG) - On this page / på denna sida - XIV. Urine - VI. Pathological Constituents of Urine - Sugar in Urine
<< prev. page << föreg. sida << >> nästa sida >> next page >>
Below is the raw OCR text
from the above scanned image.
Do you see an error? Proofread the page now!
Här nedan syns maskintolkade texten från faksimilbilden ovan.
Ser du något fel? Korrekturläs sidan nu!
This page has never been proofread. / Denna sida har aldrig korrekturlästs.
820 URINE.
quantity of protein, and an increase in the latter above the average causes
a diminution in the elimination of acetone (Rosenfeld, Hirschfeld,
Fr. Voit 1
).
The carbohydrates cannot be considered as material for the forma-
tion of acetone bodies. It is generally admitted that in man the
exclusion of carbohydrates from the food or the diminution in their
amount or their assimilation may lead to more or less increased elimina-
tion of acetone bodies. This behavior may occur in diabetes as well as
in starvation and in the above-mentioned diseased conditions. The
increased elimination of acetone with food lacking carbohydrates also
occurs in healthy persons with a fatty diet but with a sufficient supply of
calories in other ways (alimentary acetonuria). With an abundant
supply of carbohydrates the elimination of acetone bodies may be greatly
diminished or even stopped entirely. The carbohydrates therefore
act " antiketoplastic," and a similar retarding action can be produced
by certain other substances, such as glycerin (Hirschfeld), lactic acid
and glutaric acid (Baer and Blum) alanine and asparagin (Forssner,
Borchardt and Lange 2
). Certain bodies like glycerine, lactic acid,
alanine, asparagin, which cause a sugar formation or increased elimina-
tion of sugar, act in the same way.
It must not be overlooked that the conditions are different in man
and in other carnivora (Geelmuyden, Fr. Voit). In dogs the elimina-
tion of acetone bodies is not increased in starvation, but is reduced; it
is augmented with increased quantities of meat, runs parallel with the
nitrogen excretion, and is not diminished by carbohydrates (Fr. Voit 3
)
.
In spite of this divergent behavior an unmistakable relation also exists
in the dog between the elimination of acetone bodies and the carbo-
hydrate metabolism, because in phlorhizin diabetes the acidosis occurs
only after the glycogen has been consumed (Marum 4
).
As the carbohydrates cannot be acetone-formers, then a second
source only remains, namely, the fats. As proof of this there are certain
cases of diabetes with strong elimination of acetone bodies (/3-oxybutyric
acid) where the quantity of protein transformed was too small to account
for the acetone bodies (Magnus-Levy). The free elimination of acetone
bodies in starvation may also depend upon the fact that a great part of
1
Hirschfeld, Zeitschr. f. klin. Med., 28; Geelmuyden, see Maly’s Jahresber., 26,
and Zeitschr. f. physiol. Chem., 23 and 26; Rosenfeld, Centralbl. f. innere Med., 16;
Voit, Deutsch. Arch. f. klin. Med., 66.
2
Borchardt and Lange, 1. c; Hofmeister’s Beitrage, 9; which also cites other
works; Baer and Blum, ibid., 10; Forssner, Skand. Arch. f. Physiol., 25.
1 See footnote 1.
4
Hofmeister’s Beitrage, 10.
<< prev. page << föreg. sida << >> nästa sida >> next page >>
