1911 Journal of the American Medical Association  
Horion: In a dog, nine months after the pancreas v as separated nom the duodenum, total sclerosis of the gland was found al autopsy. The site of the pancreas wns occupied by a thick-walled duel, (he epithelium of which had proliferated. In tbe wall of connective tissue were no acini or islands of l.angcrhau.s. but Lere and there were a few epithelial cells. Although the tolerance for carbohydrates was greatly reduced in this dog it did not develop diabetes. At Ihe operation a triangular portion
more » ... of pancreas measuring 1 cm. on each side was left connected with the duodenum und surrounding a large pancreatic duct. At autopsy this part of the gland also was found completely atrophied. Trypsin was demonstrated in the duodenum and also in the dilated pancreatic duel. This as well as other observations show that a. minute amount of scleroeed and atrophied pancreatic tissue is sullieienf to prevent the development of diabetes. A dog has been kept ulive two and a half years after separating the pancreas from the duodenum and it has never developed diabetes. The intestinal contents of this animal do not contain trypsin. This dog's toléranos for glucose could be raised to the normal by feeding fresh pancreas cither of the sheep or pig. It remained at the nonnal level for over a month after pancreas was withdrawn from the diet, and then slowly fell to a low point. This was a female dog and she was a puppy when atrophy Of the pancreas was induced by separating the pancreas from the duodenum, she bus never menstruated and there has been an arrest of mental development, so that she still behaves like n puppy although now three years old. Bits of the pancreas were transplanted into the spleen. Dogs and cuts were used in these experiments. Most of the grafts disappeared in a few days, but well preserved acini surrounded by granulation tissue were found after thirteen days. A graft of pancreas connected with a mesenteric stalk was placed in (he spleen. Later the remainder of the pancreas was extirpated and the mesenteric vessels running to the graft In the spleen were cut. The dog did not develop diabetes. In fact its tolerance was higher than in animals in Which atrophy of the pancreas was produced. Some Experiments to Determine the Nature of the Toxemia in Acute Pancreatitis Dus. ,'lou.N SPK-CSE) It. G. TOBBBÏ and .Ioseph Sailer, Philadelphia^I n 1908 we reported investigations which showed that after the expérimentai! production of acule puncreatitis the blood-sci'um becomes intensely toxic to guineapigs and dogs, the only animale on which it was tested. This toxemia bad already been noted by f.uleke and Von Bergmann, by Doberaucr and inferred by I lildebrand and Williams, who were unable to lind bacterial infection in certain cases of acute clinical and experimental pancreatitis. Guleke and von Bergmann believed I hat the symptoms were due to the absorption ol trypsin. Our results are as follows: Dogs were operated on in the. usual way. that is the abdomen and the duodenum are opened and about 20 CO. of oil injected into the duct of Wii'sung. In from six to ten hours, if the injection is successful, the animals are moribund. They are then bled to dent It. I'"' serum collected and tested in various ways. It is to be noted thai the blood in these cases i--usually of a chocolate-brown color. We have not yet endeavored to determine the cause of this change. The clot is oft ami the serum is always deeply colored. The toxicity of the hi.I was tested in guinea-pig8 in the manner described in our previous paper. Incidentally Dr. Kelt; us discovered ulcération of the gastric mucous membrane in all respects similar to that observed by him and Df-Loeb in various experimental intoxications. Our methods for detecting trypsin were as follows: Blood-serum was diluted with an equal amount of one -lililí normal sodium carbonate solution and a small amount of chloroform-water added. This was digested for twenty-foul' hours. It was then tested for the amount of uncoagulable proteid by the Kjeldabl and the Volhord methods. There was no différence between the digested specimens and the controls-As nearly us could be judged there was no difference in the intensity of the biuret reaction, (ither portions t>f the bloodserum were then mixed with equal parts of a saturated solution of ammonium sulphate and the filtrate tested for trypsin ns before. There was no evidence of any digestive effect. The blood-serum -was I lien mixed with varied proportions ot an arbitrary solution of starch, incubated and tested with Folding's solution for the presence 01 glucose, but the Fehling solntion was not reduced. All these tesis were repealed wit'1 commercial preparations of pancreas ami were positive. As we could not find any evidence of a fat-splitting ferment m the Commercial preparations of the pancreas we did not attempt to lind it in the blood-serum. The results are therefore negative. This may be due I" the absence of either the proteolytic or the amylolytic fermenta in the blood-serum or to faulty methods or to faulty technic. Negative results are always inconclusive because a single positive result will destroy their significance, but we feel justified in saying that at the present time there is no reason to believe that the toxemia of acide pancreatitis i3 caused by tbe absorption of any of the oxternnl secretions of the pancreas. Some Observations on a Pancreatic Cyst Dr. Henry A. Christian, Boston: In a man, aged 42. fourteen months before admission to tbe hospital swelling of tin-legs began, followed two months later by the development of ascites. During a period of two months the abdominal fluid was withdrawn (bree times; and after the third tapping did not reappear. Soon after the third tapping, about ten months before admission to the hospital a gnawing pain appeared in tbe upper abdomen with occasional sharp pat'O*' ysnis. Four months before admission .a large lump appeal'1'" in the upper abdomen to disappear after a month and a half» Five weeks before coining in this lump reappeared and continued to be present. There was a large bulging tumof extending from beneath the ribs to an inch and a half jlbove the umbilicus, elastic, smooth, moving slightly with respira» tion. apparently a cyst, crowding the stomach up and tl"' transverse colon down. At operation this was found filled with a slightly viscid fluid, dark brown in color, containing changed blood. The wall of tbe cyst showed granulation tissue and no epithelium. The fluid withdrawn from t'"' cyst was slightly alkaline and did not; reduce Fehlings solution. It failed to give a trypsin reaction and did not digest coagulated egg albumen nt body temperalure, either as it came from the cyst or after the addition°' scrapings from the duodenum. In the incubator at body temperature at the end of twenty-four hours it had acquired the power of reducing Folding's solution, and previous boiling did not prevent this reducing substance from appealing. Kept at a température, however, of 00 C, no such reducing substance appeared, and preservation in the ice box for one month did not result in its appearance. The reducing substance so p"0' duced was fermented by yeast, with the production of gas. The Production of Glyc03uria with Extracts of the Hypophysis Dn. Joseph L. Miller, Chicago: Tho work on this subj' ' 1' 1 lias been more or less conflicting, llorchurct has obtained Downloaded From: by a University of Iowa User on 05/28/2015
doi:10.1001/jama.1911.04260070152041 fatcat:vy3w5arhdfhszh5fdi6ul52rzq