Diabetes: its pathological physiology / by John J.R. Macleod.

  • John James Rickard Macleod
Date:
1913
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Licence: In copyright

Credit: Diabetes: its pathological physiology / by John J.R. Macleod. Source: Wellcome Collection.

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    in the glycogenic function of the liver appear—first of all an inability of the liver cell to fix the glycogen (Neubauer, 17), so that, when dextrose is injected in the circulation, the hyper- glyceemia which is thus caused persists for much longer than in normal animals, and later a disappearance of the power to synthesize carbohydrate out of amino-acids, etc. (glyconeo- genesis). There are possibly many other conditions of poisoning by drugs in which disappearance of glycogen is unassociated with the development of hyperglycsemia, and it would undoubtedly be of great value to know much more than we do at present regarding the relationship between the two. From the above observations regarding this relationship in ether anaesthesia and in phosphorus-poisoning it can at least be concluded that hyper- glycogenolysis is not necessarily accompanied by hyperglyccemia. To take up in detail all of the other conditions which may lead to disturbances in carbohydrate metabolism would be of little profit, but to complete this chapter it may be well to say a few words concerning the effect of haemorrhage and of muscular work on the control of sugar in the blood. The effect of hcemorrhage has been made the subject of special investigation within recent years by Rose (18), Schenck, Ander- sen, Nishi, and Rona and Takahashi. Many of the experiments have been performed on rabbits, in which, being small animals, the effects of the removal of even small amounts of blood become very marked. Some of the most interesting results concerning the behaviour of the blood-sugar are as follows : Schenck (19) found that, after the removal of 25 c.c. of blood (which in an ordinary rabbit constitutes from one-fourth to one-third of all the blood), an appreciable hyperglycsemia became developed in about fifteen minutes, but subsided after a couple of hours. In starved animals, or in those in which the liver had been removed from the circulation, haemorrhage did not have this effect. Andersen (20), also using rabbits, obtained more striking results, a distinct hyperglycsemia being evident in five minutes after the removal of about one-tenth of the total blood-volume. (The percentile increase in blood-sugar was found in some cases to amount to 64-5 in five minutes, and 91-7 after thirty minutes.) By fermentation with yeast and titration of the fermented solu- tion with Bang’s solution, it was thought that some of this sugar
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