GLYCOSURIA.
Definition.—Evacuation of urine con taining sugar in sufficient quantity to be revealed by the ordinary tests.
Symptoms.—Glycosuria is a symptom occurring under various conditions and compatible with perfect health; transi tory glycosuria does not give any morbid symptoms and is only revealed by exam ination of the urine.
Case of a man, aged 25, who accident ally discovered the presence of sugar in his urine. He had no symptoms what ever of diabetes. He was the oldest of 11 children, and examination of the speci mens from the other 10 showed high spe cific gravity and the presence of more or less sugar in all. They were all healthy and passed a normal quantity of urine. The patient passed about 10 per cent. of sugar a day, but this quantity could be somewhat reduced by an exclusive milk diet. L. C. Wadsworth (Med. Record, May 29, '97).
The amount of sugar contained in the urine may be determined by various tests (ride DIABETES MELLITUS), Of which Troinmer's and Fehling,'s arc commonly preferred.
Etiology.—Glucose, or dextrose, is a constituent of normal urine, but it is present in too small a quantity to be dis covered by the ordinary tests. By the aid of the phenylhydrazin test, however, the presence of a small amount of glu cose may be revealed in every sample of urine. Pavy estimates the quantity of sugar formed in healthy urine to be 0.5 per mille. The quantity of sugar con tained in the urine is dependent on the amount of sugar present in the blood. According to experiences of Pavy, normal blood contains 0.6,-1 per mille of glu cose; v. Noorden states that the urine will contain sugar enough to be revealed by the ordinary tests as soon as the amount of sugar in the blood exceeds 0.2 per cent. This may he obtained experi mentally by ingestion of large quantities of sugar, and in this form of glycosuria alimentary glycosuria — the variety of sugar in the urine is always identical with that ingested: By ingestion of dextrose, glycosuria, or dextrosuria, is caused; by the ingestion of lactose, lactosuria; sac charose, saccharosuria, etc.
The amount of sugar necessary to pro duce glycosuria in a healthy person has been found to be:— Of dextrose, or glucose, more than 150 250 grammes.
Of saccharose, more than 200 grammes.
Of levulose, more than 200 grammes.
Of lactose, more than 120 grammes.
When the stomach is full even larger quantities can be absorbed without caus ing glycosuria. Alimentary glycosuria cannot be produced in healthy persons by ingestion of starch.
[Sliura (Zeits. f. Biol., B. 32) took one morning 1200 grammes of rice cooled in water—containing 30S grammes of starch; he experienced no consecutive glycosuria. F. LEvisoN.] According to Rosenfeld, physiological glycosuria can be differentiated from the pathological variety by the administra tion of a starch, such as that contained in white bread. It always causes an in crease in the glucose in the urine of dia betics, but does not influence the sugar in normal cases.
In the urine of lying-in women lactose generally appears between the second and fourth days of lactation; it again dis appears after a short time. When the secretion of milk is suddenly stopped large quantities of lactose are for some time excreted with the urine.
[Zuelzer administered sugar of milk to lying-in women ("Inaugural Disserta tion," Berlin, '951 and found that this substance is more easily eliminated in the puerperal state than in the normal state. F. LET rsoN.] In women during gestation the admin istration of 100 grammes of grape-sugar followed by appearance of from 1 to 18 grammes in the urine. Alimentary gly cosuria frequently found in the course of traumatic neuroses, and in cases of phosphorus poisoning, in which fatty degeneration of the liver has occurred, 20 per cent. of the sugar administered is excreted in a few hours. Jakseh (Ceutralb. f. innere Med., May 25, '95).
In various diseases alimentary glyco suria is more easily produced than in health; this has been tried by giving small quantities of sugar (less than 150 grammes of glucose) to patients suffering from various diseases. The result of these experiences has been very unsatis factory. Diseases of the brain, the spinal cord, the peripheral nerves, the muscles, and functional neuroses do not seem to predispose to alimentary glycosuria.