Page:The Harveian oration 1912.djvu/25

Rh Diabetes shall be my between-maid—in part functional, in part perhaps otherwise. What morbid anatomy have we not sought in this disease, and have not found it? Long indeed have many of us hovered over the alterations we had hoped to find, and have not found them. Changes in the nervous system; in the pancreas; in the liver; in the blood, and so on.

To my mind there is no more splendid and yet pathetic figure in the whole range of medical history than that of Pavy. In early life he set himself to unravel the pathology of diabetes, and in so doing he planted himself with correctly fore-casting eye at the spot that made victory certain—and to my mind he won it by taking the first parallel; but it may be doubted if he himself quite realized that he had done so, and there are those to-day who certainly think that he was defeated. I am not of that opinion. It has always seemed obvious, when one considers how greatly the output of sugar varies even under the most rigid system of dieting, that the excreted sugar could not be a mere output of what has been taken in—that the human kiln has, in fact, the power of in some way coining sugar out of its own constituent elements; and I believe that Pavy’s ultimate credit for a real step onward in this still most intricate disease will rest upon his observation that the proteid molecule is in some way split up, and that a carbohydrate molecule emerges therefrom. Still other parallels need assault. The question has now to be answered, What causes this seemingly inveterate sugar craze