360 DIGESTION AND RESORPTION OF FATS 



rich in fat the lymph vessels begin to show injection with 

 the milk-white chyle from that level of the bowel where 

 these two secretions become mixed with the intestinal con- 

 tent. Dastre made a very similar observation in the dog, in 

 which animal he ligated the bile duct and opened the gall 

 bladder by a fistula into the middle of the small intestine, 

 below which point mixture of the chyme first took place 

 with the bile, the commingling of the pancreatic secre- 

 tion occurring, of course, normally. A long series of obser- 

 vations on animals and man, in which after exclusion of one 

 of the two secretions or of both the utilization of fat was 

 manifestly reduced, proved the fact that normal digestion 

 of fat presupposes the combined effect of both secretions. 29 

 According to the clinical observations of T. Brugsch acute 

 or chronic degenerative pathological processes in the pan- 

 creas of man impair the fat absorption to a very consider- 

 able degree (50-60 per cent.) ; but if in addition to the 

 disturbance of the pancreatic secretion there is associated 

 a cessation of the normal biliary flow the loss of fat may 

 amount to as much as 80 to 90 per cent. that is to say, the 

 bulk of the fat leaves the intestine unabsorbed. It may be 

 readily understood why by artificially furnishing bile and 

 pancreatic juice one may succeed in favorably influencing 

 disturbances occasioned by the loss of these secretions. So, 

 too, the addition of bits of pancreas to the food may appre- 

 ciably improve the utilization of fat, according to the state- 

 ments of Sandmeyer. 30 



C. Voit, 1882; F. Rohmann, 1882; F. Muller, 1887; J. Munk, 1890; 

 Minkowski and Abelmann, 1890; A. Dastre, 1891; Sandmeyer, 1894; Harley, 

 1895; HMon and Ville, 1897; Rosenberg, 1898; Albu, 1900; A. Schmidt, 1905; 

 F. Umber and T. Brugsch, Arch. f. exper. Pathol., 55, 164, 1906; T. Brugsch 

 (Umber's Clinic), Zeitschr. f. klin. Med., 58, 518, 1906. Literature) upon the 

 Importance of the Bile and Pancreatic Secretion for Fat Digestion : J. Munk, 

 Ergebn. d. Physiol., 1, 323-325, 1902; O. Prym, Handb. d. Biochem., 3", 116- 

 118, 1909; E. H. Starling, ibid., pp. 228-230; A. Magnus-Levy, Handb. d. 

 Pathol. d. Stoffwechsels, 2d., 1, 32-39, 1906. 



W. S'andmeyer (Physiol. Instit., Marburg), Zeitschr. f. Biol., 81, 12, 1895; 

 Inouye and T. J. Sato, Arch. f. Verdauungskr., 17, 185, 1911; M. Adler (Sena- 

 tor's Clinic), Zeitschr. f. klin. Med., 66, 302, 1908. 



