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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    to occur with the digestion ijvoducts themselves when circum- stances exist to lead to their demonstrable presence in the blood. All experimental work affords testimony of sugar standing in the same position as salines and urea in relation to the property of passing oS with the iirine. Impermeability of the kidney to sugar is, as I have before ■ stated, a pure FICTION RAISED UPON THE FALSE CONCEPTION of healthy urine being free from sugar. Facts show that the urine, indeed, stands in very sensitive relationship to the blood with respect to sugar. The behaviour of Fehling's solution may be considered to be answerable for having led' to the error that has existed. It is now well understood that, whilst Fehling's solution is a test of extreme delicacy for sugar when in a pure state, the constituents belonging to the urine mask the reaction when the sugar is present in urine in small quantities only. After a long and hard struggle, the existence of sugar in healthy urine has come to- be admitted, but a disposition to minimise its significance to the utmost possible extent is still noticeable. The misconception that has so long prevailed has operated' as a misguiding factor in connexion with the fundamental idea belonging to the glycogenic theory that the carbo- hydrate of our food is destined to pass through the circula- tory system to the tissues in the form of sugar. In Michael Foster's textbook on Physiology, at p. 613, we find it stated: '' Now, a small amount of sugar is normally present in the blood, and so long as this normal amount is not exceeded no ■ siu/a/r appears in the urine [the italics are mine]. If, how- ever, by some reason or other, the sugar in the blood is increased beyond that normal amount, the excess passes- unchanged into the urine. And, the excess in the blood which thus leads to the excretion of unchanged sugar, is so- small that we might expect it to be oxidised in the blood did the blood possess any considerable oxidising power. The identity of the idea here expressed with that expressed in the quotation from the author of the article in Hill's Recent Advances in Physiology and Biochemistry given in Lecture I., shows how deeply the groundless idea has- become rooted in the minds of physiologists. The misleading nature, upon a vital point, of such a con- ception cannot be otherwise than obvious to everyone. It