v INTEENAL EESTITUTIVE SECEETIONS 283 



the fat previously stored up in the body, which is eliminated by 

 intestinal excretion when the internal secretion of the pancreas is 

 wanting ? Certain observations of Lombroso tend to justify this 

 bold hypothesis. 



He noted excess .of fat in the faeces of certain depancreatised 

 animals, when fasting or fed with plain egg-albumin. If kept on 

 a mixed diet, the faeces contained more fat than is supplied with 

 the food. A similar phenomenon has previously been recorded by 

 Harley, but to a less extent, so that it came within the limits of 

 experimental error. In some other cases Lombroso observed that 

 the fat present in the faeces of depancreatised dogs, while not in 

 excess of that introduced with the food, had a different melting- 

 point. 



These observations (to which we shall return in speaking of 

 the excretory functions of the intestine) show the complex origin 

 of the fat present in the faeces after extirpation of the pancreas. 

 It cannot be taken as an exact expression of defective absorption 

 due to deficiency of the lipolytic enzymes. 



Eat absorption in dogs with a complete fistula of the gall- 

 bladder was more particularly studied by Voit (1882), Eohmann 

 (1882), Fr. Miiller (1885), I. Munk (1890), He'don and Ville 

 (1897). The results obtained by these observers agree fairly well 

 together. Those of Munk deserve special attention. He compared 

 the absorption of different kinds of fats in a dog of 23 kilos., oper- 

 ated on 6 months previously by a biliary fistula. He found that 

 67 per cent pork fat (in a dose of 3'50 grms. to each kilogramme 

 of the animal) was absorbed, while only 36 per cent was absorbed 

 of mutton fat, which has a higher melting-point. Absorption was 

 increased if, instead of these neutral fats, the corresponding fatty 

 acids were administered. 



The form in which the fats reappear in the dejecta is chiefly 

 that of free fatty acids (Eohmann, Miiller, Munk, He'don). Voit 

 alone assumes that the form of neutral fat predominates. 



It is more important to determine the alterations in the diges- 

 tion and absorption of fat, when both pancreatic juice and bile are 

 simultaneously excluded from the intestinal canal, the former by 

 extirpation of the pancreas, the latter by fistula of the gall-bladder. 

 The effects of this double operation were studied by H6don and 

 Ville in their experiments on two dogs, which only survived the 

 operation 12 and 22 days. They found that the digestive dis- 

 orders, already conspicuous after removal of the pancreas, were 

 accentuated after the bile had been cut off. The two animals 

 became more voracious than when the pancreas alone was extir- 

 pated. They speedily exhibited a marked disgust for fat. After 

 some days the faeces showed bloody streaks, and the emaciation and 

 debility became excessive. In the last days of life the dejecta were 

 blackish (melena), and death occurred with symptoms of exhaustion. 



