A NOTE ON THE INFLUENCE OF THE CIRCULATION ON THE UTILIZATION OF CARBOHYDRATES'

In a recent paper published in this JOURNAL, Lennox and Bellinger (1) have presented the results of an extensive study of the blood sugar curves of non-diabetic individuals, following the repeated oral and intravenous administration of glucose. They find that in the majority of their subjects the blood sugar curve was higher at the initial trial than it was 1 to 312 days later, after sugar administration had been repeated. In view of these findings Lennox suggests that he is "loathe to conclude that a lowered second curve is necessarily due to treatment or to experimental procedure. " He suggests that the lowering of the height of the second curve is to be ascribed to the influence of the first ingestion of glucose. Prominent among the work cited is that of Cajori, Crouter and Pemberton (2) on the effect of changes in the circulation on carbo-hydrate utilization. The purpose of the present communication is to show that Lennox's criticism of the interpretation of repeated blood sugar curves does not apply to the above mentioned work of the present writers. Cajori, Crouter, and Pemberton (2) found that an exaggerated and prolonged hyperglycemia following the ingestion of glucose could be induced in a certain proportion of patients with chronic arthritis by interference with the blood supply to large muscle masses through elevation of the legs. The results of these experiments seemed of considerable significance in that they offered, with other evidence, an explanation of certain of the pathological changes in arthritis; and, of the delayed sugar removal from the blood ("lowered sugar tolerance") 1The work here reported is part of a study on chronic arthritis in collaboration with R. B. Osgood, M.D., of Boston. The expenses were defrayed by contribu-tions from various sources, including a number of patients