25B 



Recapitiilaiion : 



1. Normal blood, in a higher degree still blood from the pan- 

 creatic vein, aids the glycogenesis of tlie liver. 



2. Alcoholic extracts of the pancreas seem to have the same effect. 



3. The material which incites this action is thermostable. 



FIFTH SERIES (E). 



We considered the following problem. If it is a fact that the 

 pancreas furnishes the venous blood with a substance, that promotes 

 the glycogenesis, it follows that in the case of experimental pancre- 

 atic diabetes, when especially also the liver-glycogenesis is disturbed, 

 a favourable influence of this blood upon the progress of the disease 

 must be noticeable. We have set ourselves the task to ascertain this. 



Method. Of some dogs the pancreas was extirpated in the following 

 way: With the utmost attention to asepsis the abdomen was opened 

 by an incision parallel to the right arcus costalis. While the bleeding 

 was being stopped with due care, the pancreas was searched for 

 and extirpated after Hedon's method. An essential characteristic of 

 this process ib that no ligatures are applied along the duodenum, 

 but that the pancreas is separated from the duodenum by scratching 

 with a sharp nail and the bleeding is staunched only by plugging 

 vigorously with a tampon ; anotlier characteristic is that particular 

 caution is given to ligation of a small vein, which joins the tail of 

 the pancreas to the spleen. Now in reality Hedon's method applies 

 to extirpation of the entire pancreas in two stages (part of the 

 proximal extremity of the pancreas, which is provided with a sepa- 

 rate vascular bundle, is transplanted under the skin of the abdomen). 

 However, extirpation of the entire pancreas did not answer our 

 purpose, because it quickens and aggravates the pathological progress 

 to such an extent that it becomes difficult to watch the effect of 

 some therapeutic procedures. We did not see the necessity for trans- 

 planting part of the pancreas, and only left a piece of it intact (at 

 a rough estimate 2 to 3 grs) in the neighbourhood of the place 

 where the ductus choledochus enters into the duodenum. An 

 additional advantage of this method is that icterus, which often 

 ensues from an extirpation of the pancreas, can be avoided. 

 The abdomen was irrigated with a warm physiological solution, 

 after which the different layers were closed successively. Most 

 times the animals recovered pretty soon. We subjoin the exper- 

 iments which resulted in diabetes after a partial excision of the 

 pancreas. Parenthetically I wish to recall to mind an extirpation, 



