Abstract
Auer-Kleiner 1 have found that the administration of morphine of definite dosage to dogs, in which the pancreas had been injured experimentally, caused a very marked rise in the blood sugar, lasting several hours. The administration of opium and its derivatives in the treatment of diabetes mellitus has been a common practice for many years. Many noted observers ascribe beneficial results to this agent. Even today opiates are commonly used in diabetes, particularly in painful conditions, which often complicate this disease.
The observations of Auer and Kleiner are therefore of interest and importance, not only from the standpoint that the administration of morphine to diabetic suspects might (in a very simple manner) give a clue as to the existence of the disease, but they would throw light also on two other phases; namely, (I) the relation of glycosuria to pancreatic disorders; (2) the effect of morphine on the course of the hyperglycemia in diabetes. In other words, if morphine is capable of superinducing a hyperglycemia in animals with pancreatic injury, the increase of a hyperglycemia after the use of morphine in a diabetic individual or its development in a diabetic suspect, would indicate, on the one hand, that a pancreatic disturbance is present; on the other, that the beneficial effects of morphine (as regards pain, etc.) are accompanied by undesirable developments.
I have applied this test in a number of diabetics, both in the sugar-free and the glycosuric states, with the object of determining whether or not the results obtained in experimental animals occur in the human being. The dose of morphine used, given hypodermically, was 1/4 of a grain (0.015 g.). This dose is relatively small compared to that used by Auer and Kleiner, in their experiments on dogs; but it is the maximum dose that I felt justified in administering to patients.
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