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

  • Pavy, F. W. (Frederick William), 1829-1911.
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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    portal vein can be ligatured and the liver extirpated, without interfering with the circulation through the other abdominal organs. In one recorded experiment, the liver was extir- pated after the administration of 25 grammes of dextrose and 25 grammes of starch. During the succeeding 10 hours, 220 cubic centimetres of urine were collected, which, on subjection to alcoholic extraction, yielded an indication of the presence of 0-5 gramme of dextrose. A further 200 cubic centimetres were secreted during the night, and this was found to be free from sugar. In a second recorded experiment, 75 grammes of dextrose were employed. During 12 hours after the operation, 330 cubic centimetres of ui-ine were obtained in which 4-2 grammes of dextrose are stated to have been found, which represent a minute portion only of the dextrose administered. The intestinal contents, it is mentioned, only contained a trace of sugar. Eck's fistula is the name given to an operative junction of the jjortal vein with the inferior cava, permitting of the former vessel being tied above the junction and thus cutting off the flow through the liver without interfering with the circulation through the abdominal viscera. The operation is naturally a very delicate and risky one, but it has proved susceptible of being performed upon dogs with survival of the animals in a satisfactory condition for a considerable time afterwards. Hahn, Massen, Nencki, and Pawlow have published a communication in Schmiedeberg's Arohivcs,^ containing the results of observations on the effects of the opera- tion upon the system. The operative part of the under- taking was iDerformed by Massen and Pawlow, and the chemical part by Hahn and Nencki. A striking effect noticed was the production of an intolerance of animal food. The dogs subsisted well upon bread and milk, but meat pro- duced a toxEemic state accompanied with various mani- festations of nerve disturbance. The authors state that they never found albumin, albumose or sugar in the urine, but there is no indication of any idea of looking for sugar in connexion with carbohydrate food administration as a sequence of the position in which the liver was placed. A communication entitled On Carbohydrate Metabolism in Dogs with Eck's Fistula, whereby the Portal Blood passes direct into the Vena Cava without traversing the 2 Band xxxii., p. 161,1893.