DISTURBANCES OF PANCREATIC METABOLISM 659 



emulsified form, such as milk. After partial extirpation of the gland, 

 absorption was much better (fat 31.5 per cent, emulsified fat (milk) up to 

 80 per cent). 



Abelmann contributed one further important fact, namely, that fat 

 splitting even in totally depancreatized animals had not. materially been 

 interfered with ; split fats ranged as high as 30-85 per cent. 



Minkowski, and von Mering and Minkowski(a), performed an interest- 

 ing series of experiments upon total extirpation of the pancreas. When all 

 but a fraction of the tail of the pancreas had been removed, fatty stools 

 appeared but no other disturbance was noted. When, at subsequent opera- 

 tion, the atrophic remnant of the tail was extirpated, a severe diabetes 

 resulted. Thus was established the important relationship between the 

 pancreas and carbohydrate metabolism. The disturbance was credited by 

 these authors to the removal of an " internal secretion" of the pancreas. 



Further experimental evidence on the effects of partial extirpation 

 followed. Sandmeyer extirpated all except the tail of the gland; nitro- 

 gen absorption remained good, but fat absorption was materially inter- 

 fered with, in some cases falling to zero in others remaining as high as 

 30-78 per cent. Harley repeated these experiments with very similar re- 

 sults; considerable loss of fat and nitrogen was shown to follow partial 

 pancreatectomy. 



Hedon and Ville found that after total pancreatectomy a dog absorbed 

 only 18 per cent of lard or oil. In all cases the splitting of fat was well 

 maintained. 



Instead of extirpating the pancreas Rosenberg ligated completely all 

 the ducts, arteries, veins, leading to the pancreas, thus causing complete 

 blockage to the exit of ferments, as well as a consequent atrophy of 

 the gland. Under these circumstances absorption of food elements re- 

 mained nearly normal (90 per cent). He thus established the theory that 

 the persistence of the gland in the body, though atrophic and though sepa- 

 rated from the intestine, preserved digestive absorption. He attributed 

 this, however, to the fact that ferments were absorbed vicariously into the 

 circulation and reexcreted by the intestinal mucosa, a supposition which is 

 nowhere substantiated by later facts. 



The findings of Zunz and Mayer convincingly showed that though in 

 dogs the pancreatic ducts were firmly ligated and an atrophy of the pan- 

 creas produced, yet little of digestive disturbance ensued. If the atrophied 

 remnant of pancreas was removed, food absorption suffered materially. 

 As Minkowski and von Mering had done, these authors concluded that an 

 internal secretory function of the pancreas controlled absorption. 



Thus far we have noted two general conclusions: First, that total 

 destruction or total removal of the gland leads to marked disturbance in 

 the intestinal absorption of fat and nitrogen as well as of carbohydrate 

 metabolism ; second, that separation or ligation of the ducts even though 



