Temporary glycosuria may result from strangulation of the duodenum or je junum in man, but that this condition exerts no unfavorable influence upon the course of the wound, and affords no con tra-indication to general anaesthesia. F. Neugebauer (Wien. klin. Woch., Sept. 10, '96).
Glycosuria is a symptom of cancer of the pancreas. It only shows itself in the early period and disappears toward the end. Francois Guillon (Gaz. MCA. de Nantes, July 23, '9S).
Five cases of men who, after tramping the country for longer or shorter periods, showed temporary glycosuria. In each patient the liver was enlarged, greatly in two, and more resistant than in health, but gave no signs of any marked cir rhosis. They had led an unsettled life, and their food had been meagre and poor. In hospital, on a mixed diet, rich in car bohydrates, the sugar rapidly disappeared from the urine in each instance. Hoppe Seyler (Miinehener med. Woch., Apr. 17, 1900).
In giving a summary of observations and experiments upon the pathology of adrenalin glycosuria the writers point out that its intensity and duration de pend partly upon the method of admin istration and partly upon the dosage. Direct applications to the surface of the pancreas of an exceedingly small quan tity of adrenalin usually cause a con siderable excretion of sugar, while the reaction becomes less in direct propor tion according as the administration is intravenous, intraperitoneal, or subcu taneous, the result being slightest after dosage by the mouth. This relative in ertness when administered by the mouth appears to be due to the readiness of adrenalin to become oxidized, thus los ing its blood-pressure-raising properties, and when in the stomach a considerable proportion is destroyed before absorp tion takes place. Experimentally paint ing the pancreas of a dog with 0.01 gramme grain) of adrenalin sub stance was productive of 23.4 grammes (4 drachms) of glucose; but the sus ceptibility of different dogs to reac tion varies considerably. The sugar of the blood becomes regularly increased, but falls rapidly with the decline of the sugar in the urine, the volume of which latter is distinctly in excess, and this occurrence of glycosuria was shown to be independent of changes in the gen eral blood-pressure. From observations upon the sugar of the blood of the femoral artery, portal vein, and hepatic vein before and after pancreatic paint ing with adrenalin the relative excess in percentage in the hepatic vein after treatment points to an increased pro duction of sugar in the liver. That
adrenalin in producing glycosuria acts chiefly upon the cells of the pancreas is presumed from the fact that the glyco suria is more marked after painting on —or injections into—the gland than after similar treatment of the brain, spleen, liver, or kidneys. The action of potassium cyanide in producing glyco a suria, when applied to the gland sub stance, while it has no such effect when introduced into the circulation or into other organs, lends support to the theory that the pancreas is chiefly concerned in the production of adrenalin glycosuria, the glyeogenetic function of the liver being stimulated through the sympathetic nervous system. Adrenalin exerts its influence probably by a toxic action upon the cells of the pancreas, more especially in the islands of Langer hans, though lesions of these structures were not a constant accompaniment hi experimentally produced glycosuria, and when present were generally associated with alterations in other structures as well. That the adrenals normally in fluence carbohydrate metabolism by virtue of their internal secretions seems highly probable, but experimental evi dence so far does not afford complete proof, since the glycosuria which follows even slight compression or injury to these organs may be due to some nerv ous influence as yet imperfectly under stood. Herter and Wakeman (Amer. Jour. of Med. Sciences, Jan., 1903; Brit. Med. Jour., April 11, 1903).
Clycosuria gravidarum may arise at any stage of pregnancy. It 1, not so serious as when diabetes antedates pregnancy. It may disappear in one pregnancy and reappear in another, and end fatally after successive attacks. It frequently arose during parturition, but is of no great importance. Labor is not materially affected, other conditions be big equal. Pregnancy is most likely to be interrupted. Is very destructive to the foetus, even more so than syphilis. The maternal mortality is nearly 50 per cent. Diabetics should not marry. Death is usually by coma, no case of eclampsia having ever occurred in a diabetic. William Ruoff (Amer. Medi cine, April 25, 1903).