THE PANCREAS AS AN ENDOCRIN GLAND 703 



sugar in the body. They considered two possibilities, either that the pan- 

 creas normally destroys some ferment or poison in the body, so that after 

 the destruction of the gland this substance causes an elimination of the 

 sugar, or that the destruction of sugar in the organism is a normal function 

 of the pancreas. Although von Mering and Minkowski did not use the 

 expression "internal secretion" which had been introduced by Claude 

 Bernard, in 1855, with reference to the glycogenic function of the liver, 

 there can be no doubt that such a function of the pancreas was in their 

 minds. 



In the latter part of the same year appeared the report of the investi- 

 gations of de Dominicis who had likewise been successful in producing 

 diabetes through removal of the pancreas. In 1891, this author raised the 

 question of priority, but as von Mering and Minkowski's publication pre- 

 ceded his by six months, and their conclusions were so different from 

 his, there can be no doubt that the honor of this epoch-making discovery 

 belongs to them, although de Dominicis has not been given sufficient credit 

 for his apparently independent discovery of the main fact of pancreas- 

 diabetes. 



During the next few years the work of von Mering and Minkowski 

 was repeated and confirmed by many investigators (Lepine, Hedon, Gley, 

 Thiroloix, Harley, Capparelli, Schabad, Sandmeyer, Cavazzani, Seelig, 

 Aldehoif, etc.), their general results agreeing, with more or less variation 

 as to details. A few workers, as did Remond, failed to conquer the tech- 

 nical difficulties of the experiment, and, as a result, denied the connection 

 of diabetes with the pancreas. Experimental proof multiplied until it 

 was shown that, not only in dogs, but in cats, rabbits, swine, toads and 

 frogs also, extirpation of the pancreas is followed by diabetes. In fowls, 

 the removal of the organ leads to a hyperglycemia without a constant 

 glycosuria, owing to the holding back of glucose by the ' kidneys. In 

 1892, Minkowski made a full and extremely clear report of the progress 

 made by himself and other investigators since his first communication 

 with von Mering in 1889. The new points gained were the extension 

 of the experimental demonstration of pancreas-diabetes to other animals, 

 the proof that partial extirpation of the pancreas gave rise also to a more 

 or less pronounced glycosuria dependent upon the amount of the gland re- 

 moved, and the very important demonstration that a fatal diabetes could be 

 prevented by leaving portions of the organ in place, or by transplanting 

 such pieces, either within the abdomen or subcutaneously, and that sub- 

 sequent removal of the transplants was followed by diabetes. Further, 

 it was shown by Minkowski that removal of the salivary glands, thyroid, 

 duodenum or mesentery might lead to transitory glycosuria not in any- 

 way comparable to the effects produced by removal of the pancreas. 

 He also showed that phloridzin diabetes had nothing in common with 

 the pancreatic. He thus greatly strengthened the case for the pancreas 



