248 PANCREATIC DIABETES 



before the times are ripe for it, and in a sense it is in the 

 air). 



Although it must be reluctantly confessed (for that mat- 

 ter it would be recognized all too soon even without such a 

 confession) that to-day, after almost a quarter of a century 

 has elapsed since this discovery, we are not in position to 

 offer a satisfactory explanation of the real nature of pan- 

 creatic diabetes, yet it is impossible to mistake the fruitful 

 influence which even this single possible means of artificially 

 producing a metabolic disturbance analogous to human dia- 

 betes has had on the whole field of physiology and pathology 

 of metabolism. 



Interrupted Extirpation of the Pancreas. It is well 

 known that extirpation of the whole of the pancreas is requi- 

 site to produce a typical pancreatic diabetes, and that the 

 preservation of a small portion of the gland will suffice to 

 prevent this metabolic fault. If the bulk of the gland is re- 

 moved and the rest located subcutaneously diabetes does not 

 ensue, but will promptly follow with all its symptoms upon 

 subsequent removal of the transplanted portion. The fact 

 that it is possible to cause a diabetes of the severest form by 

 a trivial interference requiring but a few minutes for its com- 

 pletion, in which the peritoneal cavity is not opened at all and 

 in which there can be no question of irritation of the system 

 of peritoneal nerves, eliminates all objections, as Minkow- 

 ski 2 properly suggests, to the belief in a direct relation 

 between diabetes and loss of pancreatic function. An inter- 

 rupted process, recently suggested by Hedon, 3 makes the ex- 

 tirpation of the pancreas in the dog, which is by no means 

 easy of technic, decidedly less difficult. It is best in carrying 

 out the procedure to first remove only the gastrosplenic 

 portion of the gland and to transplant the lower part of the 

 tail of the organ with its nervo-vascular pedicle under the 



2 O. Minkowski, Pfltiger's Arch., Ill, 13, 1906. 



E. HMon (Montpellier), Arch, intern, de Physiol., 10, 350, 1911; cf. 

 therein Literature. 



