The Pancreas as an Endocrin 



Gland 



Pathology and Etiology 



A. S. WAKTHIN 



ANN ARBOR 



The present position of the pancreas as an endocrin gland may be 

 briefly stated '.The islands of Langerhans constitute an endocrinal 

 entity in that they regulate the body's use of the sugar formed from the 

 food, and that disturbances of this function lead to diabetes. This is the 

 view accepted by the great majority of writers to-day. Its extreme repre- 

 sentation may be found in the pronouncements of Allen : "It is necessary 

 to keep clear the definition of diabetes as a deficiency of the internal secre- 

 tion of the islands of Langerhans," "There is no diabetes with a normal 

 pancreas." "Diabetes is synonymous with pancreatic disease." 



This conception of the islands of Langerhans as endocrin organs is 

 supported by certain essential and undisputed facts: 



1. The experimental removal of the entire pancreas leads to a fatal 

 diabetes. 



2. The removal of portions of the pancreas, as little as one-fourth or 

 one-third, but not exceeding seven-eighths of its mass, leads to varying 

 degrees of a tendency to the development of hyperglycemia and glycosuria 

 when glucose is given by the stomach or subcutaneously. An animal may 

 be brought so near to diabetes that this condition may be precipitated by 

 the removal of as little as 0.1 gm. additional tissue. A subsequent con- 

 traction or degeneration of the remaining portion may also give rise to 

 diabetes. 



3. In totally depancreatized animals the occurrence of diabetes may 

 be prevented by the transplantation into such animals of portions of pan- 

 creati'c tissue. Subsequent atrophy or degeneration of the transplant will 

 also be followed by diabetes. 



4. The destruction of the entire acinar portion of the pancreas with 

 preservation of the islets, as may be brought about through closure of its 

 ducts, produces no glycosuria. 



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