THE PANCKEAS AS A~N ENDOCKIN GLAND 699 



Evolution of the Endocrinal Conception of the Pancreas 



The evidence presented by the literature may now be examined. The 

 mass of this relating to diabetes has reached such a magnitude that it is 

 impossible in an article, of necessity so limited as this one, to present it 

 adequately, hence there shall be attempted only a survey of the evolution 

 of the conception of the pancreas as an endocrin organ in a very con- 

 densed form, with statements of conclusions reached or of facts demon- 

 strated without details of experimental methods or observations. This 

 evolution has proceeded along the lines of anatomico-physiologic, path- 

 ologic and biochemic observation and experimental investigation ; but these 

 will be taken chronologically together rather than to consider these various 

 lines of development separately. 



Early Anatomico-physiologic Conceptions of the Pancreas. The 

 earlier anatomists and physiologists regarded the pancreas as not abso- 

 lutely essential to life or to health. In 1682 Conrad Brunner removed 

 large portions of the organ from dogs without noting any change in 

 the condition of the animal. It was not until 1856 that further inves- 

 tigations were made in this direction, when Claude Bernard attempted 

 unsuccessfully to remove the gland completely. He then attempt- 

 ed ligation of the ducts and to shut off the pancreatic juice by inject- 

 ing oil into them. As a, result he noted the presence of fat in the 

 feces. Later investigators (Schiff) failed to confirm these results. 

 Berard and Colin, in 1858, also attempted the total extirpation of the pan- 

 creas. They failed to observe the disturbances of digestion noted by Ber- 

 nard, but found on autopsy that small portions of the pancreas still re- 

 mained, to which, however, they were not inclined to ascribe any func- 

 tional activity of importance. Klebs and Munk, in 1869, experimented 

 with the definite aim of establishing a relationship between the pancreas 

 and diabetes mellitus, attempting both ligation of the ducts and extirpa- 

 tion of me organ. They found no sugar in the urine, but the animals 

 lived so short a time that the urinary examinations were not systematic- 

 ally carried out. It is also uncertain as to how much of the pancreas re- 

 mained behind. The experimenters concluded that the coincidence of 

 pancreatic affections and diabetes in man could be referred to coincident 

 lesions of the solar plexus. Schiff (1872) repeated the experiments of 

 Bernard, injecting paraffin into the excretory ducts of the pancreas in the 

 effort to produce a complete atrophy of the gland. The animals thus 

 experimented upon showed no signs of digestive disturbance and appeared 

 to be perfectly healthy. In 1883, Claudia Ulesko, according to Truhart, 

 was the first to ascribe to the pancreas a an internal secretion of a gland 

 within a gland. 7 ' Antedating Laguesse by ten years and Minkowski by 

 seven, Ulesko's thesis was buried in the Kussian journal WratscJi and 



