Three lectures on the pathology and treatment of diabetes mellitus viewed by the light of present-day knowledge / by F.W. Pavy.

  • Frederick William Pavy
Date:
1908
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Licence: In copyright

Credit: Three lectures on the pathology and treatment of diabetes mellitus viewed by the light of present-day knowledge / by F.W. Pavy. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    -transport took place in the form of free sugar through the •circulation to the seat of iitilisatioQ in the tissues. And yet the view is still seen in some quarters to receive credence. For instance, an a propos illustrative case is to be found in the article on the Metabolism of the Carbohydrates con- tained in as late a publication as Leonard hill's work on '' REGENT ADVANCES IN PHYSIOLOGY and Bio-Chemistry, 1906. The article was written by Pro- fessor J. J. E. Macleod, now in Cleveland, U.S.A., but formerly a demonstrator of physiology at the London Hospital. Let us look into what is said, and give an eye to the groundwork on which the credence is based. The article starts with notifying that carbohydrate matter constitutes the greater portion of our food and then specify- ing that it may.range in standard daily dietaries, constructed for different amounts of muscular work, from 240 to 700 grammes. The consideration of how this carbohydrate becomes disposed of within the system is next entered into and dealt with upon lines falling within the teachings of the glycogenic doctrine. Notwithstanding the professed nature of the work in which this article is contained—of the work itself it may be said that, looked at as a whole, it has ably and usefully met a want that existed—it is found that in the article what can be unreservedly spoken of as obsolete errors are in an unqualified manner adopted and made use of as a groundwork for the conclusions set forth. For instance, in antagonism with the showing of all modem work, it is assumed that the sugar normally x^resent in the blood does not pass out with the urine and that it is only when it stands in excess of 2-0 per 1000, which is put down as constituting the maximum representation of the normal range for the sugar constituent of the blood, that it shows itself in the urine. With a normal percentage (of sugar) in the blood, the kidney allows none of the sugar to pass into the urine, but whenever this percentage is exceeded, immediate leakage of the excess through the kidney Alter occurs (p. 313). Such is the physiology that is ijlaced before advanced physiologists in connexion with this matter! The first part of the statement is demonstrably untrue, and the second part is pure fiction. What is there to determine that below 2 per 1000, there shall be no escape, and above, an escape of sugar 1 The whole thing is not only contrai-y