The effect of ligation of the hepatic artery on carbohydrate metabolism.

Abstract

In the course of some experiments on the physiology of the liver of the dog, we observed that ligation of the hepatic artery caused death of the animals in convulsions. Previous investigators'* 2s observed death in convulsions in animals after complete circulatory exclusion of the liver. Mann and Magath4 found that after complete hepatectomy their dogs died in hypoglycemic convulsions. We, thewfore, undertook the study of the relation of the blood sugar level to the convulsive seizure following ligation of the hepatic artery.There was a remarkable constancy in the results obtained. After coming out of the anesthetic, the dogs appeared normalwalked, ran, barked, drank water and excreted normal amounts of urine and feces. The dogs remained in this apparently normal state from 15 to 50 hours, following which they became drowsy, listless, and unresponsive. Pinching or pricking did not call forth any response. The animals refused food and water. During this stage uccasional fibrillary twitches were observed. Then (within 1 to 2 hours) they manifested symptoms of hyperirritability, hyper-reflexia and a sudden onset of generalized clonic convulsions followed by tonic spasms, retraction of the neck, respiratory paralysis, an occasional sharp yelp, and death. This general seizure usually lasted from 2 to 5 minutes.

The Effects of Complete and of Partial Removal of the Liver

“…These experiments have been criticized severely by subsequent investigators because the circulation is so greatly damaged The blood sugar level and condition of hypoglycemia. Collens, Shelling and Byron (27) showed that exclusion of the arterial supply to the liver by ligation of the hepatic artery and its collaterals results in death with hypoglycemic convulsions. Minkowski (157), in his classical research on the effect of removal of the liver in geese, noted a decrease in blood sugar.…”

Reports of Officers

“…The total number of subscribers, other than Fellows, Jan. 1, 1927, was 33,705, an increase of 1,592. Table A presents an approximate count of Fellows and of subscribers, Jan. 1,1927, and indicates the gain or loss in each state and territory that year over the previous year. The total receipts from the sale of advertising space in the publications of the Association for the year 1926 were $798,059, which represents a handsome gain over the receipts from the same source in the preceding year.…”

“…That after Jan. 1, 1928, no hospital will be approved for the training of interns which does not have a record of necropsies on at least 10 per cent of all deaths in the hospital each year; that after Jan. 1,1929, the minimum requirement will be 15 per cent, and that the hospitals on the list having less than these percentages be promptly notified of this requirement.…”

“…A brief résumé and averaging of the replies to question¬ naires and other questions from twenty-three states and two provinces reflects: (1) No shortage of nurses except in rural regions, an increasing supply during the last five years. (2) Fifty per cent of graduates remaining in the vicinity of their nursing schools.…”

“…Amend Chapter IV, Section 4, of the By-Laws to provide for the election of officers as the fifth item on the order of business at the meeting of the House of Delegates on the fourth day of the session (Thursday), so that the order of business shall be: 1 The notice was given at the Dallas session by Dr. Horace M. Brown, delegate from Wisconsin, that the foregoing amendment to the By-Laws would be offered at the Wash¬ ington session.…”