DISTURBANCES OF PANCREATIC METABOLISM 671 



TABLE IV 

 FAT AND NITROGEN EXCRETION IN CALCULOUS CIRRHOSIS OF PANCREAS 



setting up an extensive inflammatory reaction and atrophy. Fat losses in 

 atrophy due to calculus average 18.8 per cent, nitrogen loss 39.4 per cent; 

 proteid metabolism evidently suffers more than does fat digestion. 



Malignant Tumors of the Pancreas 



Under this heading are grouped, not cases in which merely the duct 

 has been blocked by a small epitheliomatous new growth of the diverti- 

 culum or papilla of Vater, but cases in which the carcinoma has ex- 

 tensively invaded and destroyed secreting tubules. 



In these cases we note the fat loss ranging between 28.2 per cent and 

 85 per cent, averaging 62.14 per cent; nitrogen loss is not so extensive, 

 ranging between 11 per cent and 41 per cent, averaging 28.34 per cent. 



TABLE V 

 FAT AND NITROGEN EXCRETION IN TUMORS OF THE PANCREAS 



This is the first group of cases in which as a whole the loss of fat is 

 consistently over 50 per cent, thus fulfilling the dictum of Brugsch (d] who 

 required 50 per cent or more, and of Tileston who required a loss of 60 

 per cent or more as clearly indicating pancreatic disease. Apparently 

 there are more "factors of safety" (Meltzer) in, nitrogen than in fat 



