NOTE on the ETIOLOGY of TYPHUS FEVER

Abstract

To rightly see the position, more delicate testing than that xesorted to by Voit requires to be adopted. The examination of the blood shows that even two hours after the injection it has not recovered its normal condition. There is a further point that the experiments show in a decided manner, and that will therefore have to be considered by physiologists, namely, that notwithstanding that dextrose has been used, what is found in the urine, and, after the lapse of a little time, likewise in the blood, is a product of much lower cupric oxide reducing power. Baisch's7 results obtained from normal -urine stand in accord.Towards the conclusion of his article Dr. Paton says: " The evidence may therefore be considered as establishing (i) that glucose is formed in the liver; (2) that glucose is used in the tissues, and is not all excreted by the kidneys." That gluoose is susceptible of being formed in the liver is a truism with which everyone is familiar. Under a great variety of 4bformal conditions abundant evidence is forthcoming showing that sugar escapes from the liver, and its escape is made manifest by its inflnence upon the blood and the urine. As -regards the second proposition, whilst I. contend that the ,entrance of sugar into the circulation is revealed by its influence upon the urine-that the urine, in fact, staads as an indicator of the state of the blood in relation to sugar-it has mot been in my mind that all the sugar that may happen to reach the blood is eliminated by the kidney. At page 236 of my Physiology of the Carbohydrates, I say, in connection with the consideration of the subcutaneous injection of glucose: "I have referred to the protoplasmic transmutation of sugar into glycogen in the liver. But the transmutative power by no means exclusively belongs to the liver; indeed, T am disposed to think it exists as a general property of the protoplasmic matter of the body."What we have broadly to deal with is the application of our food supply of carbohydrate matter within the animal system. Under the glycogenic doctrine, everything is centred in the liver. The liver takes the carbohydrate, stores it as glycogen, and then gives it out to pass as sugar into the circulation, to be conveyed to the tissues for oxidation, and thence heat, or some other form of force-production. Sach was the ,doctrine propounded for the disposal of carbohydrate matter within the animal system; and, further, to meet the want of the tissues, if-the tangibly evident supply was not afforded by the food the liver was alleged to form it out of other material, it not being then realised that with animal food we get a certain amount of supply of carbohydrate matter, sufficient, it appears to me, to account for the glycogen found under the oircumstances in the organ. What is the alimentary form of diabetes but this passage of the carbohydrate matter of our food into the general circulation as sugar, and do we not, by -cutting down the supply of it, protect the system from the sugar invasion, and thereby bring the urine to a natural ...