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those who uphold this contention. Let us, then, in the briefest possible way, state the principal facts on which the existence of pancreatic diabetes is affirmed. This was shown first by Professor Lancereaux, in 1877, who presented to the Paris academy morbid specimens of natural viagra online the pancreas. Two years subsequently Lapierre confirmed this view. "The disease," as he describes it, ''begins suddenly, and manifests itself by intense thirst and hunger, then by abundant polyuria with sugar oscillating between three hundred and six hun- dred grams per day, and rapid emaciation, with loss of all the forces, and finally complications (broncho- pneumonia, diabetic coma, phthisis) that carry off the patient." ' In twenty cases fourteen showed atrophy of the pancreas well pronounced. These observations were still further verified by the remarkable results of von Mehring and Minkowsky"s experiments, who extirpated the pancreas in dogs. They found that sugar appeared in the urine a short time after the extirpation of the pancreas and persisted until death of the animal, and, " in addition to the gly- cosuria, there was great thirst, h.unger, and rapid ema- ciation." Dominicis, the Italian physiologist, who formerly held a contrary opinion, has also embraced this view, and in his late series of experiments attained identical results. Redmond, Marinisco, and Chaput also hold the same natural viagra online opinion and conclude "that total destruction of the pancreas produces permanent diabetes." " He- don excised the pancreas in twenty-two dogs, and in each case diabetic urine was passed the day after and persisted until death, with all the characteristic symp- toms of saccharine diabetes." ' Thiroloix, as a result of his numerous experiments, arrived at the same con- clusion. Professor Le'pine, who was co-referee in the recent Lyons congress, has recorded forty cases of complete removal of the pancreas in dogs. " After complete removal he has always noted the appearance of sugar in generic viagra safemeds the natural viagra online urine within generic viagra safemeds forty-eight hours, and the diabetes is permanent. He believes that the blood has the power of constantly destroying glucose by the action of a ferment made in the pancreas (glycolytic ferment). This ferment is diminished in diseases of the pancreas and wanting when that gland is de- stroyed." Thiroloix has modified his former theory, and has adopted Lepine's conclusion " that the pan- creas produces the principal glycolytic ferment which natural viagra online destroys glucose in the blood," and thus prevents its reaching the urine. De Renzi and generic viagra safemeds Reale, generic viagra safemeds as a result of their many experiments, assert that diabetes is caused in seventy-five per cent, of all animals in which they have entirely extirpated the pancreas. ''Min- kowsky, in reviewing his work, says that diabetes never fails to appear after complete removal of the pancreas if the animals live long enough after the ex- tirpation. This statement is founded on fifty-five ex- periments made on dogs. Three times only did sugar fail to appear in the urine, but the dogs succumbed during the first twenty-four hours." 3 Le'pine, in his communication to the recent con- gress, natural viagra online October 29, 1894, defines his glycolytic theory: " The ' ferment ' is taken up by the leucocytes and car- ried by them to the tissues, where it aids glycolysis." Minkowsky, by an ingenious experiment, proved that if a portion of the pancreas (of an animal from which it had been extiqoated) was transplanted be- neath the peritoneum, the diabetic condition was averted, only to appear when the transplanted organ natural viagra online was removed by a further operation. The pancreas may be destroyed by connective-tissue or fatty overgrowth, by tumors, or by calculi, and dia- 1 generic viagra safemeds Abstract in Medical Record, April 20, 1895. 2 Loc. cit., p. 494. 3 Loc. cit., p. 494. MEDICAL RECORD. [May 23, 1896 betes thereby result. The most frequent lesion is simple atrophy, and, according to Housemann, may be found generic viagra safemeds in corpulent diabetics as well as generic viagra safemeds in the emaci- ated. Cysts of the pancreas also sometimes produce diabetes. Bull, of New York, recently operated on generic viagra safemeds a diabetic subject, and on post-mortem examination found a cyst of the pancreas. Churton, of London, had an identical experience, and if time permitted nu- merous similar cases could be cited. This and other adducible evidence shows, this con- clusion being unavoidable, that a relationship really exists in the great majority of cases between the pan- creas and grave diabetes mellitus. An admirable re- sume of the subject appeared recently in the Boston Medical and Surgical Journal, to which the reader fs referred if he cares to pursue the inquiry still further. In addition to the authors quoted whose views favor this contention, the work of Comby, Tiessier, Charrin, Renault, Glenard, and others are recorded in extenso. The rational conclusion deducible from this study is that "grave" diabetes mellitus is due in the great ma- jority of cases to degenerative or destructive lesions of the pancreas, which impair or destroy the gland's function of pouring into the blood through the generic viagra safemeds lym- phatics the glycolytic ferment, the presence of which in the blood determines the destruction of sugar. But it may be asked, Does the acceptance of this theory bring us one step nearer a remedy for this hith- erto incurable malady than we were before? Its at- tempted answer involves a consideration of the third proposition stated in the beginning of this paper. Professor Le'pine, of Lyons, 1 entertaining the belief that the arrest of the destruction of sugar is owing to an absence or deficiency of the diastasic ferment, re- cords the result of treatment of four cases of grave