682 BURRILL B. CROHN 



to 22.5 per cent. No improvement was seen under specific pancreatic 

 therapy. 



It is of interest that a brother of this child who died in infancy also 

 showed steatorrhea. 



Robson and Cammidge express as their opinion the fact that these 

 cases are instances in which the pancreas is sufficient up to about the age of 

 eleven ; about the time of puberty physical and sexual development is ar- 

 rested. The actual pancreatic disease is however probably congenital 

 since in most of these cases the alvine defecations were present from 

 birth. The only exact chemical data in congenital pancreatic disease 

 are those of Garrod and Hurtley(c) ; their figures indicate definite metab- 

 olic disturbance of the pancreatic function. 



Opotherapy in Pancreatic Disease. This is an interesting and develop- 

 ing chapter in the field of metabolism disturbances. 



Abelmann found in partial pancreatectomized animals, that a protein 

 absorption of only 30 to 80 per cent could be raised and maintained at 

 74 to 78 per cent by the feeding of raw pancreas gland. After total pan- 

 createctomy a total loss of fat is converted into a considerable absorption 

 of fat on gland therapy. Sandmeyer found similar results. Pratt, Lam- 

 son and Harks found in dogs with the pancreatic ducts tied off, that con- 

 siderable improvement in absorption resulted from feeding raw gland 

 to the animals; pancreatic extracts were less efficacious, the pankreon in 

 one experiment brought the fat absorption up from 11.3 per cent to 48.5 

 per cent and the nitrogen absorption from 22.2 to 52.1 per cent. Lom- 

 broso(fe) on the other hand failed to find improvement in the absorptive ca- 

 pacity of his dogs after exhibiting to them pancreatic broths, or pancreatic 

 extract or even the duodenal juice of a healthy animal. 



In general, pancreatic extracts, or the fresh gland when administered, 

 have shown beneficial results at the bedside. Weintraud with pancreatin, 

 Harley with the whole gland, Salomon with pankreon (a commercial dry 

 extract hardened with tannin), Ernst Meyer with a combination of pan- 

 kreon and opium all found marked improvement. The last showed by 

 exact chemical data that absorption of nitrogen and fat was almost doubled. 

 Oscar Gross (a) found pankreon useless but asserts that the fresh pig's 

 gland greatly improves absorption. 



Masuyama and Schild found marked improvement with pankreon. 

 Thus on a mixed diet there was a utilization of 36.9 per cent fat and 

 37.2 per cent protein; after exhibiting the raw gland absorption rose to 

 63.6 and 45.3 per cent respectively. 



Glaessner and Sigel demonstrated chemically the best results with 

 pancreatin and bicarbonate of soda. Empirically, Barbour(a) tried to im- 

 prove absorption by hydrochloric acid administration, hoping to stimulate 

 secretion and thus the flow of pancreatic juice. No result was seen, but 

 a good result is reported with pancreatin and calcium carbonate. 



