252 PANCREATIC DIABETES 



existence of pancreatic diabetes as established beyond 

 peradventure. 



Does the Internal Secretion of the Pancreas Pass with the 

 Lymph Through the Thoracic Duct into the Blood? We 

 may, however, proceed farther and take up the question 

 whether the presence of an internal secretion influencing the 

 carbohydrate metabolism can in any manner be directly 

 recognized in the blood. 



At the outset an interesting fact observed by Biedl n 

 may be mentioned, namely, that in dogs in which the thoracic 

 duct is tied or opened through a fistula, glycosuria will 

 usually occur. This fact has been verified in Gottlieb's 

 laboratory, 12 and has been supplemented, too, by clinical 

 observations of the occasional coincidence of chyluria and 

 glycosuria, 13 Naturally one feels a strong temptation to 

 interpret these observations on the hypothesis that the 

 lymph duct is carrying to the blood, a secretion originat- 

 ing in the pancreas the cessation of which occasions the 

 glycosuria; but it cannot be settled offhand whether the 

 glycosuria may not have been induced in some very differ- 

 ent way in such cases (as by nervous irritation, etc.). 



Blood Transfusion and Parabiosis. Besides there is at 

 least a chance that this "internal secretion " of the pancreas 

 does not gain entrance into the general circulation indirectly 

 by way of the lymph passages, but directly into the blood ves- 

 sels. It is true the blood of the pancreatic vein has shown 

 no influence upon sugar elimination in a dog with the pan- 

 creas removed. 14 But when Hedon united two dogs by 

 anastomosing their carotid arteries, one deprived of its 



10 W. Kausch (Naunyn's Clinic), Arch. f. exper. Pathol., 37, 274, 1896; 

 M. Lowit (Innsbruck), ibid., 62, 47, 1909; V. Diamara (Siena), Arch. Ital. de 

 Biol., 55, 94, 1911; cf. therein the Literature. 



U A. Biedl, Centralbl. f. Physiol., 1898, 624; Biedl and Th. Offer (R. Pal- 

 tauf's Lab.), Wiener klin. Wochenschr., 1907, 1530. 



J. L. Tuckett, Jour, of Physiol., 41, 88, 1910. 



18 A. Magnus-Levy, Zeitschr. f. klin. Med., 66, 482, 1908; 67, 524, 1909. 



14 A. Alexander and R. Ehrmann ( Berlin Pathol. Instit., Dept. Exp. Biol. ) , 

 Zeitschr. f. exper. Pathol., 5, 367, 1909. 



