EXTIRPATION OF PANCREAS 361 



Influence of Extirpation of the Pancreas Upon Fat Re- 

 sorption. Taking up here the question of the mode of 

 action exercised by the bile and pancreatic secretion on fat 

 resorption, brief reference may be appropriately made first 

 to the ideas which U. Lombroso has evolved as to the in- 

 fluence of the pancreas. These rest upon the statement 

 made by a number of authorities, that it is by no means the 

 same thing for proper utilization of the fat whether we 

 merely ligate the pancreatic ducts or completely extirpate 

 the whole gland. Thus Eosenberg after the first procedure 

 noted no striking disturbance of fat utilization in dogs ; but 

 as soon as he entirely ablated the gland (already markedly 

 degenerated in sequence to the ligation), marked disturb- 

 ance ensued. 31 Observations of the same sort were repeat- 

 edly made by U. Lombroso, 32 E. Fleckseder 3S and P. C. P. 

 Jansen. 34 The first of these suggested the theory (with 

 reference to the fact that after total extirpation of the 

 pancreas there may at times be observed fatty degeneration, 

 crowding of the fat depots of the body and even fat secretion 

 into the intestine) that the pancreas may be involved in in- 

 terruption of the natural process of fat metabolism not only 

 by loss of the mixture of its external secretion with the intes- 

 tinal contents, but also by an internal secretion which is 

 given off into the circulating blood and by which it governs 

 the fat transformation in the same way that it regulates the 

 carbohydrate metabolism. 35 To properly interpret this idea 

 one should keep especially in mind that total pancreatic ex- 



81 S. Rosenberg, Pfliiger's Arch., 70, 371, 1898. 



82 U. Lombroso (Turin), Arch. Ital. de Biol., 42, 336, 1904; Pfliiger's Arch., 

 112, 531, 1906; Arch. f. exper. Pathol., 56, 357, 1907; 60, 99, 1908; Arch, di 

 Fisiol., 8, 209, 1910. 



38 R. Fleckseder (H. H. Meyer's Lab., Vienna), Arch. f. exper. Pathol., 59, 

 407, 1908. 



84 P. C. P. Jansen (Physiol. Instit., Amsterdam) , Zeitschr. f. physiol. Chem., 

 72, 158, 1911. 



36 0. Gross (Steyrer's Clinic, Greifswald), Deutsch. Arch. f. klin. Med., 

 108, 106, 1912, has also recently accepted with Lombroso that the steatorrhrea 

 met in pancreatic affections is due to a loss of the internal secretion of the 

 pancreas. 



