348 INANITION AND MALNUTRITION 



Mattei ('14) found the pancreas usually rather low in weight (1.5-4.0 

 g.) and pale or reddish in color in 8 cases of atrophic infants with body weights 

 of 2,200-3,100 g. The secretory acini appeared normal in structure, but there 

 was a thickening of the fibrous capsule and stroma, with marked sclerosis in 

 one case. The outer coat of the ducts and blood vessels also appeared somewhat 

 sclerotic. The pancreatic islets always appeared increased in number and 

 showed changes as follows: 



"Les formations langerhansiennes presentent, en dehors de leur abondance, 

 deux ordres d'alteration appreciables: Petat vacuolaire ou pycnotique des 

 noyaux cellulaires et la perte complete des limites des cellules langerhansiennes. 

 II y a ainsi dans de nombreux cas, comme un tassement de Pilot qui n'en con- 

 serve pas moins un volume notable La sclerose intrainsulaire est rare; nous 

 Pavons vue dans deux cas, les trainees fibreuses, tres fines, relient la coque peri- 

 insulaire au centre de Pilot affectant ainsi une disposition plus ou moins reguliere- 

 ment rayonnante." 



Mattei concluded from this evidence that the pancreatic islets (like the 

 hypophysis) show signs of functional hyperactivity in athreptic infants. Nobe- 

 court ('16) stated that there is an increased number of islets and numerous 

 transition forms to the secretory acini. Marfan ('21) also reviewed the pan- 

 creatic lesions in infantile atrophy. 



In famine-stricken children of various ages, Nicolaeff ('23) found the pan- 

 creatic weight only 10-20 per cent subnormal for age. The microscopic 

 structure is well preserved, but the cells appear small. The islets of Langerhans 

 are very distinct, and even appear hypertrophied. 



In my data from Minnesota atrophic infants (Table 3) the pancreas appears 

 variable in weight. In some cases it appears very low, in others above normal. 

 In some cases the high weight of the pancreas may be due to (unrecorded) 

 syphilitic infection. 



Among the animals, observations on the pancreas are more numerous. 

 Lucas (1826) found no marked change in the gross appearance of the pancreas 

 in starved animals of various species. Collard de Martigny (1828) in starved 

 dogs and rabbits found the pancreas very small, firm, pale and anemic. Tiede- 

 mann ('36) reviewed the earlier observations upon the gross atrophy of the 

 pancreas during inanition. Chossat ('43) found an average loss of 64.1 per 

 cent in the pancreas of starved pigeons with a loss of about 40 per cent in body 

 weight. 



According to Traina ('04), Heumann ('50) noted a diminution in the size 

 of the pancreas cells in starved pigeons. 



Bidder and Schmidt ('52) found an apparent loss of about 85 per cent in 

 the pancreas of a starved cat, with loss of about 50 per cent in body weight. 

 Bourgeois ('70) reported the pancreas in starved animals (guinea pigs, rabbits, 

 cats, dogs, etc.) as extremely atrophic and anemic, with average loss of 64 

 per cent in weight. 



Heidenhain ('75) made a careful study of the pancreatic cell structure in 

 dogs starved 30-48 hours and then fully refed with meat. He distinguished 

 a first digestive period of 10 hours, a second digestive period of 10 hours (20 



