Liebig was the first to point out the connexion between these changes and the phenomena of Diabetes. It is clear that if the process were to stop at the formation of grape-sugar, the condition of blood that exists in Diabetes would result. This sugar cannot be put to any use, and is excreted as fast as formed. There is an excess of urea in the whole quantity of urine passed in the day; probably because the nitrogenous food and tissues are undergoing combustion instead of the starch. Before becoming grape-sugar, starch undergoes a transitional change into Dextrine, a gummy insipid substance which has the same composition as itself. It seems that the process may even stop as early as this, and that by this stoppage another analogous disease may be produced, _i.e._ Diabetes insipidus. The common Diabetes is called D. mellitus. (_Vide Jones' Anim. Chem._ p. 120.)
If it were clearly proved that the acid of Rheumatic fever is lactic acid, then this affection might evidently be produced by a stoppage of the process at the next stage. Lactic acid has been formed; but, for some reason unknown, it is not oxidized into carbonic acid. Urea and uric acid are in excess in the urine, from the cause alleged above.
But suppose some of the sugar to be oxidized prematurely, without passing first into lactic acid. By this oxalic acid would be produced, and the phenomena of Oxaluria accounted for.
These things are only alleged as possible, and for the purpose of showing that, should they be true, the action of some useful remedies might be elucidated. It is not at all unlikely that the accuracy of such ideas may be completely established by fresh discoveries at no distant time. But let us continue.
In Gout and Lithiasis there is an excess in the system of nitrogenous matter, and thus a tendency to an extra formation of urea. These conditions are often brought on, and always aggravated, by over-indulgence in animal food. Now if we may suppose that some of the lactic acid, instead of oxidizing directly into carbonic acid, oxidizes in combination with this urea which is in excess, then uric acid and water might result, as is shown below. The uric acid passes out into the urine in excessive quantity.