DISTURBANCES OF PANCREATIC METABOLISM 661 



broso's fistula experiments, both with licking and without licking of the 

 escaping fistula fluid. 



Niemaun and also Brugsch(e?) offered evidence in f#vor of Lombroso's 

 claims. Both these workers found absorption of fat and nitrogen practical- 

 ly normal when all the ducts were securely tied. They both proved that 

 they had tied all the ducts, for at autopsy on their dogs no trace of tryptic 

 ferment was found in the duodenal juices. If, on the other hand, the 

 vessels to the pancreas were tied, causing atrophy and destruction of the 

 gland, fat absorption fell to 39.6 per cent and nitrogen to 62 per cent. 2 



Jansen's experiments, which were a duplication of much of Lombroso's 

 work, upholds the statements made by the latter. With a subcutaneous 

 graft as the sole representative of pancreatic tissue in the. body, absorp- 

 tion of fat was fairly well maintained varying between 67.4 per cent and 

 75 per cent. After extirpation of the graft, absorption of fat fell to 24.6 

 per cent. On a strict protein diet, more fat was excreted than actually 

 ingested. 



Convincing as these experiments and their corroboration by inde- 

 pendent workers seem to be, the matter was not to end here. For Visentini 

 demonstrated that pancreatic ducts, when ligated and cut, rapidly reestab- 

 lished their continuity with the intestinal lumen. Further he found that 

 when the ducts were thoroughly separated without removal of the pan- 

 creas, that fat absorption fell to between 20 per cent and 40 per cent. He 

 thus revives the theory that it is an essential necessity for absorption that 

 the external pancreatic secretion reach the intestine. 



More recently, valuable work in this country has contributed some im- 

 portant findings. Pratt, Lamson and Marks found a serious disturbance 

 after ablation of the ducts and insertion of omentum between the cut ends ; 

 nitrogen loss rose to 77.8 per cent, fat loss to 88.7 to 95.2 per cent 



Benedict and Pratt feeding only meat to dogs with the ducts ligated 

 found a nitrogen loss of 32.1 to 57.7 per cent. The feeding of fresh pan- 

 creas gland seemed to increase absorption. 



In both these latter groups of experiments it can be held that a pro- 

 gressive atrophy and degeneration of the gland accounted for the poor ab- 

 sorption. This was the same argument with which Lombroso retaliated 

 against his critics. In fact, Pratt and Spooner themselves point out that 

 an extensive injury results to the pancreas as a result of the extensive 

 ligation. This, they contend, is shown by the rapidly reduced ability to 

 assimilate glucose shown by their dogs. 



It would seem to the author that not sufficient recognition has been 

 given the fact that after ligation of the ducts of the pancreas alone, serious 

 injury to the parenchyma of the gland may result. It will be seen in 

 the discussion under the experimental production of acute pancreatitis 



1 The normal absorption for the dog is, nitrogen 98 per cent, fat 96 per cent, but 

 in all cases approximately 90 per cent or over. (Burkhardt.) 



