THE SPLENO-PANCREATIC INTERNAL SECRETION. 



411 



ment, thus annulling the very important functions of sugar in 

 the economy. 



It is plain that the islands of Langerhans are not the 

 source of a glycolytic ferment. Of course, Professor Lepine 

 has never, that we know of, sustained this view, his contention 

 being simply that the normal pancreas contains a glycolytic 

 ferment which finds its way into the lymph and blood, in which 

 it controls the consumption of sugar by the tissues. And his 

 experimental evidence, in the light of our views, shows this 

 to be the case, since it all goes to prove that the oxidizing 

 substance which enters the pancreatic circulation is a glyco- 

 lytic body. This does not mean that it acts therein as such; 

 indeed, the organic cells at once take up its oxygen for their 

 own functional interchanges, the blood returning to the splenic 

 veins as venous blood. But it is nevertheless obvious that Lepine 

 should have experimentally found, as he says, a glycolytic fer- 

 ment in the pancreatic blood. All we show, therefore, is that 

 Lepine's glycolytic ferment is the oxidizing substance. 



But why should disease of the pancreas under these cir- 

 cumstances increase the proportion of sugar in the urine: a 

 feature which Lepine ascribed to decrease of sugar destruction 

 and to the fact that "these lesions decrease the source of the 

 glycolytic ferment in the economy"? From our standpoint, 

 of course, the adrenals are the original source of the oxidizing 

 substance: i.e., adrenal secretion plus oxygen. But does this 

 account in an equally satisfactory manner for glycosuria? 

 This introduces a very important feature of the entire analysis, 

 one, indeed, bearing upon the pathogenesis of all forms of pan- 

 creatic diabetes. 



We have previously referred to the fact that disease of 

 the islands of Langerhans had been found to be a prominent 

 causative factor of diabetes by various pathologists, and that 

 Opie had witnessed a case in which these islands alone were 

 diseased. This obviously points to the fact that, if in accord- 

 ance with our view the ampullce of the islands are the pathways of 

 the Schiff-Herzen splenic substance to the ducts, we are dealing 

 either with obstruction or impaired conversion of trypsinogen 

 into trypsin, or both simultaneously. If, bearing this feature 

 in mind, we review the list of pancreatic diseases that cause 



