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Chemistry of the Other Secretions 1

secretion, diabetes, rule and exceptions


1. Salica Amonut.—The mouth of the diabetic, despite the large and frequent draughts of water, shows an obstinate tendency to be come dry. The saliva is as a rule scanty and poor in ferment, al though there are exceptions. In many patients the secretion is normal and in others there may even be a very amazing degree of ptyalism. In some cases I have failed to obtain the sulphocyanic reaction in diabetic saliva.

Sugar.—The accounts given of the presence of grape sugar in the saliva are very unreliable. If this substance is ever found it is only exceptionally.

Reaction.—The mixed buccal secretions are as a rule of acid reac tion in diabetes. According to the results of _Mosler's and von Frerichs' researches it appears to be certain that even the parotid secretion as it flows from Steno's duct may be faintly acid. This happens occasionally also in healthy individuals, but then only tem porarily (Sticker).

2. Gastric Juice."—The secretion of hydrochloric acid has been examined by Honigmann, Rosenstein, and Gans in twenty-eight cases of diabetes, but no law concerning it could be discovered. These authors found the secretion usually below the normal amount, in some cases variable. A diminution, if it occurs, is to be referred, according to Rosenstein, to nervous influences.

3. Intestinal Secretioos. —Since it is impossible to collect the in testinal juice in a pure state, its secretion must be estimated from an examination of the feces. It has been already stated that the feces in diabetes are as a rule normal in amount and composition, and that the absorption of nutritive material proceeds satisfactorilyp. 84).

It was also at the same time pointed out that occasionally exceptions may be met with which are to be attributed to a deficient access of the pancreatic juice.

4. Semen.—Diabetics often have increased sexual desires at the beginning of the disease, but this stage is usually of short duration and the opposite condition soon prevails. Patients frequently com plain, even in the early stages of the disease, of a loss of virile power and of a reduced seminal secretion, and these phenomena are to be counted among the regular symptoms of the later stages, if we except the mildest cases. But there are occasional exceptions to this rule. Frequently the impotence is the first symptom that leads the patient to seek medical advice.

5. Perspiration The condition of the cutaneous secretion has already been referred to on page 92. The earlier reports concerning the appearance of sugar in the sweat in diabetes were, to say the least, exaggerated (Kfilz), for the occurrence is in any case extremely rare. I have examined the sweat, after injections of pilocarpine, in six cases of diabetes, and never found any substance in which fermentation could be excited by yeast or which formed the character istic crystals upon the addition of phenylhydrazin.