1909.] Urine in Chronic Disease of the Pancreas: 377 



(II) In a second dog chronic pancreatitis was induced by passing a silk 

 thread from the duodenum along the duct of Wirsung and leaving the loose 

 end hanging free in the intestine.* The urine withdrawn three days after 

 the operation yielded crowds of long fine yellow crystals, soluble in 

 33-per-cent. sulphuric acid in 5 to 10 seconds, and which melted at 

 178° to 180° C. A second specimen taken one week after the operation 

 showed many typical crystals. A third sample obtained two weeks after the 

 operation gave some crystals, but the reaction was not as well marked as 

 that given by the preceding specimens. A fourth sample obtained one week 

 later still gave a fairly well-marked reaction. 



At the end of the next week the pancreas and part of the duodenum were 

 removed and the cut ends of the intestine united by a Murphy button. 

 Examination of the excised portions showed that the thread was still in 

 position in the pancreatic duct and hanging into the duodenum. The whole 

 pancreas, but more particularly the head of the gland, was thickened and 

 felt heavier than normal. Microscopical examination of sections cut from 

 various parts showed a marked over-growth of the interlobular connective 

 tissue, especially in the neighbourhood of the duct of Wirsung and its larger 

 tributaries. The epithelium of the duct was detached and in places lay loose 

 in the lumen. The periphery of the gland was not so markedly affected, 

 although here, too, there appeared to be some increase of fibrous tissue and 

 a few round cells were seen in and around the ducts. 



Immediately after the second operation the bladder was emptied by 

 catheter. A specimen of urine withdrawn 15 hours later was found to 

 contain T8 per cent, of reducing sugar, as estimated by Bang's method ; 

 1*6 per cent, of fermentable sugar, estimated by Lohenstein's saccharometer, 

 and the polariscope showed T2 per cent, of dextro-rotatory sugar. Treatment 

 with phenylhydrazin gave a dense precipitate of coarse greenish-yellow 

 crystals that were insoluble in 33-per-cent. sulphuric acid in five minutes, 

 and on re-crystallisation from 70-per-cent. alcohol melted at 204° to 205° C, 

 thus corresponding to dextrosazone. Forty-five cubic centimetres of the 

 filtered urine were boiled with 3 c.c. of hydrochloric acid for 10 minutes, 

 the excess of acid neutralised with lead carbonate, and the glycuronic acid 

 removed by shaking with tri-basic lead acetate. The lead in the nitrate was 

 then removed by treatment with a stream of sulphuretted hydrogen and 

 subsequent filtration. After being heated to drive off the excess of 

 sulphuretted hydrogen, the filtrate was cooled and mixed with half its bulk 

 of distilled water. Yeast was then added, and the mixture incubated at 



* Cf. Carnot, 'Gilbert et Thoinot, Traite de Medicine et de Therapeutique,' 1908, 

 fasc. 20, p. 238. 



