EXPERIMENTAL STUDIES ON DIABETES : SERIES I. PRODUCTION AND CONTROL OF DIABETES IN THE DOG. 1. GROSS ANATOMIC RELATIONS OF THE PANCREAS AND DIABETES.

1. The injurious effects of excessive carbohydrate diet are demon strable in partially depancreatized dogs, in the same manner as in human patients. With severe diabetes there is rapid progress of emaciation and weakness and early death. 2. With milder diabetes, there is frequently a transitional state following operation, when the fate depends on the diet. If the tolerance is spared for a time, recovery sometimes occurs to such extent that diabetes cannot be produced by any kind or quantity of feeding, but only by removal of a small additional fragment of pancreatic tissue. The proper degree of carbohydrate overfeeding is important in this early period for producing the most useful type of diabetic animals; namely, those having good digestion and general health combined with a permanent lowering of assimilative power, like the condition of human patients. 3. In the early stage, glucose is more powerful than starch in producing diabetes, and animals which are progressing toward complete recovery on starch diet can be sent into hopeless diabetes by admix ture of glucose. The difference seems to be merely of the rate of absorption, and indicates that a rapid flood of carbohydrate is more injurious to the pancreatic function than a slow absorption. When ever permanent diabetes is present, so that complete recovery is impossible, starch brings on glycosuria more slowly than sugar, but just as surely. The difference in time in different cases amounts to days, weeks, or months. The clinical lesson from such experiments is that even if a patient becomes free from glycosuria on withdrawal of sugar only, nevertheless other foods should also be limited. 4. No significant differences were observed between the assimilation of different starches, or any extreme lowering of the carbohydrate tolerance by proteins, such as alleged by certain writers in connection with the "oatmeal cure." 5. Repair of traumatic inflammation and hypertrophy of the pancreas remnant have been mentioned incidentally as the basis of the early tendency to recovery, and also hydropic degeneration of Lang erhans islands as an accompaniment of the lowering of tolerance by excessive diet. These are believed to have their parallels in human cases, and are to be described more fully hereafter.