THE PANCREATIC JUICE. 133 



THE PANCREATIC JUICE. 



As has been pointed out, the digestive glands which have so far 

 been considered are not essential to the maintenance of life. The 

 salivary glands and the stomach, moreover, can in certain animals 

 be eliminated without seriously interfering with the process of 

 digestion, and the ferments which in man are secreted by these 

 structures are in many animals absent. The pancreas, on the other 

 hand, either as such or as a so-called hepatopancreas, is found in all 

 vertebrate and invertebrate animals in which the process of diges- 

 tion is carried on in a well-defined digestive tube. In many, 

 indeed, it represents the only digestive gland of the body. Its 

 removal, even in the higher animals, invariably leads to death. In 

 dogs, in which this operation has been repeatedly performed, and in 

 which life may go on for a few weeks thereafter, it has been 

 observed that as a result of such interference the resorption of fats 

 is seriously impeded, so that practically all that has been ingested 

 reappears in the feces. In the case of the albumins, it is similarly 

 found that but 44 per cent, is absorbed, and of the ingested starches 

 from 20 to 40 per cent, is eliminated as such. Analogous results 

 are obtained in the human being where atrophy of the pancreas is 

 at times observed. As a consequence, rapid emaciation occurs, and, as 

 has been stated, death ultimately results. It appears, however, that 

 the fatal issue in these cases is not exclusively referable to impaired 

 nutrition as a result of defective absorption. It is, indeed, possible 

 to counteract this effect by administering a sufficient amount of raw 

 pancreas together with the food, whereby the resorption of both fats 

 and albumins is greatly improved. Death, however, takes place never- 

 theless. It is thus apparent that besides its digestive function the 

 pancreas must play an additional and important role in the metab- 

 olism of the animal body. We find, as a matter of fact, that fol- 

 lowing the extirpation of the pancreas in dogs a severe form of dia- 

 betes rapidly develops, and is accompanied by the appearance of 

 acetone, diacetic acid, and at times of /9-oxybutyric acid in the urine. 

 That this is not due to suspension of the pancreatic digestion can be 

 proved in various ways. If the animal thus receives an adequate 

 amount of raw pancreas together with its food, the absorption of 

 albumins and fats is, as just stated, greatly increased, while the 

 diabetes persists. It has been further noted that ligation of the 

 secretory duct does not lead to the appearance of sugar in the urine, 

 and that the diabetes continues after extirpation even when no food 

 is consumed for several days. The conclusion hence suggests itself 

 that the pancreas, like the thyroid, the adrenal body, and other 

 glands, probably furnishes an internal secretion also, which in some 

 manner, as yet unknown, controls the metabolism of glucose within 

 the animal body. Arthaud and Butte, it is true, claim that diabetes 

 does not follow ligation of the pancreatic veins ; but it can readily 



