704 A. S. WAKTHIN 



theory, and *in summing up all f>f the evidence concluded that the sugar 

 function of the pancreas is a specific one peculiar to this organ alone, 

 and that a deficiency of pancreatic secretion leads to a disturbance of 

 the internal metabolism of the organism. The cause of diabetes is either 

 a deficiency of a normal function which controls the use of sugar in the 

 organism, or, as the result of the extirpation of the pancreas, there is a 

 Jieaping-up in the organism of some abnormal substance, or a deficiency 

 of a normal function of the pancreas to remove a ferment-like or toxic 

 substance, the retention of which in the organism causes the elimination 

 of sugar. He regarded as the much more plausible mew, that the pancreas 

 has a normal function concerned in the utilization of sugar and the loss 

 of this function is the cause of diabetes. As to the essential nature of this 

 function only hypotheses could be advanced. 



To Minkowski, then, belongs the chief, if not the entire honor of first 

 proving conclusively that the pancreas is an endocrinal organ. This 

 view he did not express in the endocrinal phraseology of to-day ; he did 

 not even use the term internal secretion, because such a theory of en- 

 docrin metabolism and its terminology had not yet come into existence. 

 Although Claude Bernard had as early as 1855 used the expression 

 "secretion interne" in describing the glycogenic function of the liver, it 

 had not yet acquired any specific meaning. Minkowski's work went far 

 towards giving it such a meaning. Lepine (1889-91), after the first 

 papers of von Mering and Minkowski had appeared, confirmed the 

 existence of pancreatic diabetes, and in explanation asserted that the 

 pancreas furnished an internal secretion, a ferment with glycolytic 

 power, passed from the pancreas into the blood, taken up by the leu- 

 kocytes and acting as a sugar destroyer. Lepine strengthened his theory 

 by demonstrating that the glycolytic power of the blood was diminished 

 in experimental pancreatic diabetes as well as in human diabetes. Re- 

 moval of the pancreas removed this glycolysin from the blood and caused 

 diabetes. It was soon shown by Arthus, Ivraus, Sansoni, Gaglio, 

 Seegen, Colenbrander, Minkowski and others that Lepine's conclusions 

 were not justified; his methods were questioned, his statement that the 

 glycolysis in normal blood was greater than in diabetic blood could not 

 be confirmed, and the glycolysis observed by him was regarded as 

 probably due to postmortem alterations in the blood. Further, the fer- 

 ment-content of the blood alone would not have sufficed for the normal 

 destruction of sugar. Nevertheless, this work of Lepine's, misleading 

 as it was, performed a distinct service in laying emphasis on the possibil- 

 ity of an internal secretion formed in the pancreas, and the minds of in- 

 vestigators henceforth began to be concerned with this phase of the prob- 

 lem of pancreatic function and diabetes, In his critical discussion of 

 Lepine' s work and conclusions, Minkowski concludes that the conception 

 of a glycolytic ferment is not applicable to the explanation of diabetes, 



