The Threshold of Ketogenesis , 1922.

I don't know how much of an excerpt the copyright laws allow. Here is the very beginning of the paper.

I have found it worth reading several times.

From the Divison of Medicine, the Mayo Clinic, Rochester.)
(Received for publication, April 11, 1922.)


It is recognized that diets so unbalanced as to contain greatly disproportionate amounts of fat lead to the formation and ex- cretion of acetoacetic acid, p-hydroxybutyric acid, and acetone. The accumulation of these substances depends on the ratio existr ing between the ketogenic substances, particularly fatty acids and the glucose of the metabolizing foods. That ratio at which signifi- cant ketosis first appears may be called the threshold of keto- genesis. Accurate knowledge of the value of this threshold is a matter of importance in gauging the safety of diets high in fat such as may be used in diabetes. Zeller (19), Lusk (4), Ringer (7), Woodyatt (17, 18), Shaffer (8, 9), Palmer (6), Hubbard (2), Hubbard and Wright (3), and others have contributed data to the subject. Woodyatt (18) has discussed the problem with great lucidity and Shaffer (8, 9) has reported investigations which have stimulated thought and study.

With mixtures of varying proportions of acetoacetic acid and glucose in alkaline hydrogen peroxide, Shaffer (8, 9) beheld in the test-tube what he considered to be an in vitro analogy to the action of glucose in abolishing or preventing the formationof acetoacetic acid in man. When the proportion of acetoacetic acid to glucose in such mixtures was that of 1 (or possibly 2) moleculesof acetoacetic acid to 1of glucose,the former substance was completely oxidized. When the proportion of glucose was less,a considerable fraction of acetoacetic acid escaped oxidation. In these papers, Shaffer calculated the number of molecules of ketogenic material and the number of molecules of glucose in the determined metabolism of several human subjects and concluded....


* Presented before the American Society for Clinical Investigation at Washington, D. C., May, 1922.
t Fellow in medicine, Mayo Foundation. 393


Dr. Wilder was working on a way to help diabetics. Here is a short bio article on him.

https://www.diapedia.org/introducti...ll-morse-wilder