ACTION UPON FATS. 34:9 



Iii the case reported by Mr. Lloyd, the condition was the 

 same ; and in the case reported by Dr. Elliotson, " the pan- 

 creatic duct and the larger lateral branches were filled with 

 white calculi." Another interesting case of disease of the 

 pancreas is detailed in the catalogue of the Anatomical Mu- 

 seum of the. Boston Society for Medical Improvement, 184/T. 

 In this case it was observed by the patient that fatty dis- 

 charges from the bowels did not take place unless fatty ar- 

 ticles of food had been taken. After death, a large tumor 

 was found in the situation of the pancreas, but all trace of 

 the normal structure of the organ had been destroyed. 1 



Many more cases of this character are quoted by Ber- 

 nard and others, and they fully confirm the observations and 

 experiments which have been made upon the lower animals 2 

 They all seem to show that the function of the pancreas in 

 digestion is essential to life, but that one of the chief dis- 

 orders in digestion incident to the destruction of this gland 

 relates to the digestion of fats. 



Taking into consideration all the facts bearing upon this 

 subject, the conclusion is inevitable that the chief agent in 

 the digestion of fats is the pancreatic juice ; and that this 

 fluid acts by forming with the fat a very fine emulsion, thus 

 reducing it to a form in which it can be absorbed. How far 

 the bile may assist in this process is a question which will 

 come up for consideration hereafter ; but the facts with re- 

 gard to the pancreatic juice are conclusive. In making this 

 unqualified statement, it is not intended to ignore the experi- 

 ments of some of the German physiologists, which have 



1 A Descriptive Catalogue of the Anatomical Museum of the Boston Society 

 for Medical Improvement, Boston, 1847, p. 174. 



2 Dr. John H. Griscom, of New York, gives the details of an interesting case 

 of Diarrhoea Adiposa, in the Transactions of the American Medical Association, 

 1813, volume xiv., p. 173 et seq. In this case, recovery apparently took place, 

 and the patient passed from observation. He also gives a tabulated analysis of 

 twenty-five cases of discharge of fatty matter from the bowels observed by 

 various authors. It is not unusual for cases of this kind to terminate in 

 recovery. 



