ME THODS OF OB TAINING PANCREA TIC JUICE. 5 4 7 
Although, in tli!' resting condition of the gland, an outer border free 
from granules is evident, this is still more manifest in the exhausted 
condition. The granules may then be so reduced in number as to form 
small aggregations at the luminal borders only of the cells. 
As is the case in the stomach, there is reason to believe that the 
granules are concerned with the specific secretion of the gland, the 
amount of granules determining the activity of an extract. 
The above described changes in the cells were first observed in the 
living pancreas of the rabbit by Kiihne and Sheridan Lea. 1 
Methods of obtaining pancreatic juice. — The methods that have been 
adopted to procure a supply of pancreatic juice involve one of the following 
procedures— («) Fixing a cannula into the duct of Wirsung ; (h) opening the 
duct and connecting it with the body wall ; (c) cutting out a piece of the 
intestine in which the pancreatic duct opens, and fixing this to the body 
wall. 
C. Bernard - adopted the first method, fixing a silver cannula into the duct. 
Heidenhain 3 introduced antiseptic precautions into the operation. He made 
an incision in the linea alba midway between the xiphoid process and the 
umbilicus. The duodenum was drawn out through the opening and the duct 
carefully sought for. This being found, into it was tied a glass cannula 
of about 6-1 S cms. in length. Around the intestine were placed two 
temporary ligatures, keeping the gut closely applied to the body wall. The 
opening was found to gradually close, allowing simply the cannula to pass 
through. The second method was adopted by Ludwig with AVeinmann, 4 and 
Bernstein. 5 They found and opened the duct and inserted a piece of lead wire, 
on the one hand, towards the papilla pancreatica in the duodenum, the other 
end passing up to the gland substance. This wire did not fill the lumen, and 
thus the flow was still permitted. The third method, which is due to Heidenhain 
and adopted for permanent fistulse, consists in resecting the small portion of the 
intestine which contains the papilla pancreatica, and joining the ends of the 
main gut above and below. The piece of intestine is slit up, the mesenteric 
surface is attached to the body wall, and thus the juice can be obtained. 
Pawlow varied this method by not resecting the whole tube of the intestine. 
He cut out a quadrangular piece, including the pancreatic papilla, and ligatured 
this into the body wall. 
By these different methods natural pancreatic juice may be obtained. 
After a time the juice becomes somewhat altered ; it retains, however, its 
ferment activity in a marked manner throughout. 
The influence of the nervous system upon pancreatic secretion. 
— Our knowledge has lately been considerably extended in respect of 
the precise influence of nervous impulses upon pancreatic secretion. 
The following statements summarise our chief knowledge up to the 
most recent researches upon the subject. 6 
1. After division of the nerves, proceeding to the gland, secretion is set 
up and apparently increases. This was affirmed by Bernstein. 7 
2. Secretion can be set up by stimulation of the medulla oblongata, 
or, if already in progress, can be increased. 8 
3. The medulla oblongata must not be regarded as exclusively the 
1 Verhandl. d. naturh.-med. Vcr. •.» Heidelberg, N.F., Bd. i. 
- " Memoire sur le pancreas et sur le role dusuc pancreatique," Compt. rend. Acad. d. sc. 
Paris, 1856. 
3 Hermann's " Handbucli," Bd. v. 4 Ztschr. f. rat. Med., Bd. iii. 
5 Ber. d. k. sdchs. Gesellsch. d. JVissensch., Leipzig, 1869. 
6 Gf. Heidenhain, Hermann's "Handbucli," Bd. v. Abth. 4. ' Op. cit. 
8 Heidenhain, Arch. f. d. gcs. Physiol., Bonn, 1875. 
