Glycosuria From Pain
Böhm and Hoffmann found that cats, when bound to an operating board, a tube inserted into the trachea (without anesthesia), and in some instances a catheter inserted into the urethra through an opening above the pubis, had in about half an hour an abundance of sugar in the urine. In three determinations sugar in the blood proved slightly above “normal” so long as sugar was appearing in the urine, but returned to “normal” as the glycosuria disappeared. Since they were able to produce the phenomenon by simply binding animals to the holder, they called it “Fesselungsdiabetes.”
As possible causes of this glycosuria in bound animals, they considered opening the trachea, cooling, and pain. The first two they readily eliminated, and still they found sugar excreted. Pain they could not obviate, and since, without binding the animals, they caused glycosuria by merely stimulating the sciatic nerves, they concluded that painful confinement was itself a sufficient cause. Other factors, however, such as cooling and circulatory disturbances, probably coöperated with pain, they believed, to produce the result. Their observations on cats have been proved true also of rabbits;[12] and recently it has been shown that an operation involving some pain increases blood sugar in dogs.[13] Temporary glycosuria has likewise been noted in association with intense pain in human beings.
Inasmuch as Böhm and Hoffmann did not mention the emotional element in discussing their results, and inasmuch as they admitted that they could not obviate from their experimental procedure pain, which they themselves proved was effective in causing glycosuria, designating what they called “Fesselungsdiabetes” as “emotional glycosuria” is not justified.
Emotional Glycosuria
The discovery that during strong emotion adrenal secretion is increased, and the fact that injection of adrenin gives rise to glycosuria, suggested that glycosuria might be called forth by emotional excitement, and then that even without the painful element of Böhm and Hoffmann’s experiments, sugar might be found in the urine. The testing of this possibility was undertaken by A. T. Shohl, W. S. Wright and myself in 1911.
Our first procedure was a repetition of Böhm and Hoffmann’s experiments, freed from the factor of pain. The animals (cats) were bound to a comfortable holder, which left the head unfastened. This holder I had used hundreds of times in X-ray studies of digestion, with many different animals, without causing any signs of even so much as uneasiness. Just as in observations on the movements of the alimentary canal, however, so here, the animals reacted differently to the experience of being confined. Young males usually became quite frantic, and with eyes wide, pupils dilated, pulse accelerated, hairs of the tail more or less erect, they struggled, snarling and growling, to free themselves. Females, on the contrary, especially if elderly, were as a rule much more calm, and resignedly accepted the novel situation.
According to differences in reaction the animals were left in the holder for periods varying in length from thirty minutes to five hours. In order to insure prompt urination, considerable quantities of water were given by stomach tube at the beginning of the experiment and in some cases again later. Arrangements were made for draining the urine promptly, when the animal was on the holder or when afterwards in a metal metabolism cage, into a glass receiver containing a few drops of chloroform to prevent fermentation. The diet in all cases consisted of customary raw meat and milk. In every instance the urine was proved free from sugar before the animal was excited.
In our series of observations twelve cats were used, and in every one a well-marked glycosuria was developed. The shortest periods of confinement to the holder which were effective were thirty and forty minutes; the longest we employed, five hours. The average time required to bring about a glycosuria was less than an hour and a half; the average in seven of the twelve cases was less than forty minutes. In all cases no sugar was found in the urine passed on the day after the excitement.
The promptness with which the glycosuria developed was directly related to the emotional state of the animal. Sugar was found early in animals which early showed signs of being frightened or in a rage, and much later in animals which took the experience more calmly.