Although clinical evidence thus indicates an emotional origin of some cases of diabetes and glycosuria, the intricacies of existence and the complications of disease in human beings throw some doubt on the value of that evidence. Both Naunyn[54] and Hirschfeld, although mentioning instances of diabetes apparently due to an emotional experience, urge a skeptical attitude toward such statements. It is desirable, therefore, that the question of an emotional glycosuria be tested under simpler and more controllable conditions. “Emotional glycosuria” in experimental animals has indeed been referred to by Waterman and Smit[55] and more recently by Henderson and Underhill.[56] Both these references, however, are based on the work of Böhm and Hoffmann,[57] reported in 1878. 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;[58] and recently it has been shown that an operation involving some pain increases blood sugar in dogs.[59] 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