The results of these numerous clinical experiments are not con cordant. If we take into consideration, however, those investiga tions only in which proper methods for the estimation of sugar have been employed, we are brought to the conclusion that glycosuria can be induced in all these diseases with scarcely greater facility than in healthy individuals, or, in other words, an insufficiency of the glycogen reservoir can hardly be said to exist.
To come to special diseases : Affections of the brain, spinal cord, peripheral nerves or muscles, and functional nerve troubles do not favor the production of alimentary glycosuria ; Basedow's disease alone does so. Diseases of the liver: In certain cases of cirrhosis glycosuria was easily produced, but in the great majority of these cases, as also in all other forms of hepatic disorder, it was not. This is the more remarkable as in most of these diseases the hepatic tis sues adapted to the taking up of glycogen were deeply affected. In order to reconcile the apparent contradiction between the results of experiments on animals and clinical experience, we must remember that the liver is not the only organ which stores up glycogen, but that the muscle-cells and glands likewise possess this property. Possibly these bodies act vicariously for the liver in case of neces sity. The question is theoretically plausible, but up to the present
it has not been seriously handled. In diseases of the lungs and heart and in the secondary affections resulting therefrom (hyper femia of the liver, atrophic conditions, fatty liver), and also in dis eases of the blood, positive results are even more rare than in pri mary hepatic disorders.
The study of alimentary glycosuria in diseases of the glycogen storing organs may be regarded now as fairly completed, and a mul tiplication of investigations into this question is hardly needed. It was expected that they would lead to a better understanding of dia betes, but this expectation has proved unfounded. The most im portant fact which we have been able to gather from them is that the due consumption of carbohydrates in the body is not dependent upon the integrity of the liver, for the most serious diseases of this organ cause no spontaneous, and but seldom an insignificant ali mentary, glycosuria. From this we can understand why it is that theoretical writers on the subject of diabetes, who formerly referred to the liver with the greatest reverence, have come more and more to disregard this organ as a disease centre.