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Observations on the Urine in Chronic Disease of the Pancreas. 

 By P. J. Cammidge (M.D. Lond.). 



(Communicated by Sir Victor Horsley, F.RS. Eeceived April 5, — Eead 



May 20, 1909.) 



Modern researches on the physiology of the pancreas have shown that it 

 plays a much more important part in digestion than had formerly been 

 supposed, and also indicated that it exerts a very considerable influence on 

 the internal metabolism of the body. The present investigations were 

 commenced early in 1901, at the suggestion of Mr. Mayo Kobson, with the 

 object of throwing further light on the nature of these metabolic processes 

 and discovering, if possible, some more reliable means of diagnosing diseases 

 of the pancreas than is usually afforded by the clinical signs. 



The condition of the blood in patients suffering from diseases of the- 

 pancreas was first investigated, and subsequently attention was devoted to 

 the urine. The clinical bearing of the results of these observations has 

 been dealt with in my Arris and Gale Lecture, and Mr. Eobson's Hunterian 

 Lectures, delivered at the Eoyal College of Surgeons in 1904,* and also ini 

 a paper I read before the Eoyal Medical and Chirurgical Society in 1906.f 



In the course of a series of experiments designed to discover whether 

 glycerine, the soluble product of the disseminated fat necrosis met with in 

 pancreatitis, or some derivative of it, was excreted by the kidneys, I found 

 that if the urine of a person suffering from an inflammatory affection of the 

 pancreas were boiled with hydrochloric acid, the excess of acid neutralised 

 with lead carbonate, and the freed glycuronic acid precipitated out of the 

 acid solution with tri-basic lead acetate, treatment of the filtrate with 

 phenylhydrazin yielded a crystalline product which appeared to vary in 

 amount with the stage and intensity of the disease, while normal urines and 

 specimens from patients suffering from diseases in which there was no- 

 reason to think that the pancreas was involved gave no reaction. In this 

 communication I propose to describe a series of experiments I have 

 conducted into the nature of this product, and also the results of animal 

 experiments designed to discover whether the reaction depended upon 

 changes in the pancreas itself or was due to alterations in the other tissues 

 of the body brought about by a disturbance of its metabolic functions. 



For the purpose of the former investigations 4 litres of urine from 



* 'Lancet,' March 19, 26, April 2, 1904. 

 t ' Eoy. Med. Chi. Soc. Trans.,' 1906. 



