PANCREATIC FISTULAS 35 



peptic digestion interfered with. Abderhalden and his as- 

 sociates have shown that the splitting of a dipeptid, glycyl- 

 1-tyrosin, which is not produced normally in the stomach, can 

 in these cases be detected in the gastric juice by polarimetry 

 (after neutralizing the acidity of the gastric juice by sodium 

 bicarbonate). It has been proposed to base a method for 

 obtaining the human pancreatic juice for diagnostic pur- 

 poses upon this fact. In application an "oil test-break- 

 fast/' consisting of about 200 ccm. of olive oil, containing 

 free oleic acid, is introduced by a stomach-tube after neu- 

 tralization of the gastric acidity by alkali. The gastric con- 

 tent withdrawn after a half hour is readily freed from the 

 oil and often is found stained greenish by bile and may show 

 the presence of trypsin. Whether the method, for which 

 great expectations were entertained, will prove of actual 

 value in diagnosis must for the present be held in judgment. 2 

 Pancreatic Fistulas. As is well known, the chyme having 

 passed into the intestine becomes mixed with the secretion of 

 the pancreatic gland, to the secretory process of which organ 

 attention should next be called. Although Claude Bernard 

 had introduced canulas into the excretory duct of the pan- 

 creas and had endeavored to thus study the method of secre- 

 tion of this important organ, for a long time progress was not 

 satisfactory, simply because there was too great a departure 

 from the normal physiological conditions arising from the 

 severity of the operative procedure. Very often after such a 

 * ' temporary ' ' fistula has been made, even if the experimental 

 animal be in the height of digestion, but little or no secre- 

 tion can be obtained. Here again the incomparable 

 Russian physiologist, Pawlow, 3 was the first to overcome 



2 Literature upon the Passage of Pancreatic Juice and Intestinal Fluid into 

 the Stomach: Important monographs by W. Boldyreff, Ergebn. d. Physiol., 11, 

 127-213, 1911; cf. also W. Boldyreff, Pfliiger's Arch., 121, 13, 1908; E. Abder- 

 halden and F. Medigreceanu, Zeitschr. f. physiol. Chem., 57, 317, 1908; E. 

 Abderhalden and Schittenhelm, ibid., 59, 230, 1909; J. Lewinski (Minkowski's 

 Clinic, Greifswald), Deutsche med. Wochenschr., 1908, 1582. 



3 Literature upon Production of Pancreatic Fistulas : J. Pawlow, Ergebn, 

 d. Physiol., 1, 266-272, 1902; Nagel's Handb. d. Physiol., 2, 728-742, 1907. 



