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April 5, 1976


JAMA. 1976;235(14):1481. doi:10.1001/jama.1976.03260400047034

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We are taught that metabolism comprises anabolism and catabolism. What the texts neglect to mention is diabolism, a set of processes that are doubtless manifestations of diabolic intent. Some of these processes fit into the category of "inborn errors" of metabolism, with their display of gargoyles and monsters. Others, less obvious, create mischief so as to frustrate the clinician and the investigator when they least expect it.

The mediators of diabolism are diabolites, who dwell in the body's "Satanic mills." Unlike metabolites, they do not lend themselves readily to chemical analysis. For instance, years of intensive investigation have failed to identify the diabolite responsible for weight gain after a prolonged starvation diet. Alternately labeled "obesolase" and "adiposozyme," the mischievous diabolite continues to elude identification, although there are some indications that it may be a polypeptide with a mysterious side-chain that converts inhaled pollutants to fat.

Known to some as "dysbalance-ase,"