80 i:\'/.)MEH 



Fat necrosis, resulting from the escape of pancreatic juice into the 

 peripanereatic tissues and abdominal cavity, undoubtedly is largely 

 the result of lipase action. (See "Fat Necrosis," Chapter xiii, for 

 complete consideration.) 



AMYLASE 3H 



Although undt'i* ordinary conditions starch is not supposed to enter 

 the blood stream and tissues, yet all tissues and body fluids are capable 

 of hydrolyzing starch. Apparently the amylase is derived from the 

 pancreas and salivary glands, and i)ossibly from many or all other 

 tissues (King), but it is not (piantitatively related to the amount of 

 carbohydrate in the diet of a species or an individual (Carlson and 

 Luckhardt). In llic bloiMJ it occurs in the albumin fraction.'"' There 

 is disagreement in the literature as to the variations in amount of 

 amylase in the blood during disease, and little information concerning 

 its distribution in the tissues. Normally the kidneys and liver seem 

 to be most active. During acute infections the blood amylase is in- 

 creased, presumably coming from the leucocytes (King). It is greatly 

 increased when the pancreas is acutely inflamed or injured (Stocks). 

 Intravenous or subcutaneous injection of starch is said to increase the 

 blood amylase, presumably as a defensive reaction (Abderhalden), 

 but the amylase ordinarily in the blood seems to be a waste substance 

 on its way to excretion, rather than a functionating enz^one of the 

 blood. There appears to be no normal antiamylase in the blood. 



Because of possible diagnostic signiticance, the amylolytic activity 

 of the urine has been particularly studied, and found normally to be 

 approximately constant for 24 hour specimens of the same individual.*" 

 Anything impairing the excretory capacity of the kidney decreases the 

 urinary amylase, although sometimes when the urine contains blood, 

 pus, or much all)umen there may be an increased amylase excretion in 

 spite of diminished functional activity. There may be an increase in 

 the amylase in the blood when the urinary amylase is decreased, but 

 with normal kidneys increase of the blood amylase causes an increase 

 in the urine; hence, acute pancreatic diseases cause an increased 

 urinary amylase TStocks), but this is not constant (McClure and 

 Pratt). In diabetic urine it is said to l)e usually decreased, but this 

 is mostly accounted for by the dilution of the urine. Parenteral in- 

 jection of stai-ch causes a marked increase in the amount of diastase in 

 the urine (King) .'^^ 



3« Litcraluro {.nvcn bv Kinff, .Amor. Jour. Phvsiol.. 1914 (S.'i), 301; Govelin, 

 Arc-h. Int. Med., 1014 (13), 06; Storks. Quart. .Toiir. ^rcd., 1010 (0), 210; :^[c'Clure 

 and Pratt. An-h. Int. Med., 1017 HO). .'>GS. 



3»Satta, Arcli. Sci. "MM., lOlo (.10), 4(i. 



■"> In infants llio urino anivlaso is low f^[c("'Iuro and riiaiiccUdr, Zoit. Kindor- 

 hcilk.. 1014 (11), 4S:{. 



'I rrnr. So.-. Kvii, lii.il,. I'.HT ( 1.-)). 1(11. 



