Diseases of the intestines and peritoneum / by Hermann Nothnagel ; edited, with additions by Humphrey D. Rolleston ; authorized translation from the German, under the editorial supervision of Alfred Stengel.
- Hermann Nothnagel
- Date:
- 1904
Licence: Public Domain Mark
Credit: Diseases of the intestines and peritoneum / by Hermann Nothnagel ; edited, with additions by Humphrey D. Rolleston ; authorized translation from the German, under the editorial supervision of Alfred Stengel. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
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![The Pancreatic Juice.—The pancreas is the most important of the above-mentioned glands. It is fonnd in all mammals, while glands possessing similar functions to the pancreas are present in all the articu- lata. The albumin-freeing property of the pancreatic juice M^as discov- ered in 1836 by Purkinje and Pappenheim. Claude Bernard, in 1846, performed the first fundamental experiments with pancreatic secretion. Bidder and Schmidt, Corvisart, W. Kiihne, Bernstein, and Heidenhain amj)lified these experiments and obtained results which are accepted at the present time. The secretion of pancreatic juice, as was originally shown by Ber- nard and Bernstein, is dependent on digestion. [The introduction of 0.4 per cent. HCl into the duodenum or jejunum induces a flow of pancreatic juice which is not reflex, since it occurs after section of all nervous connections. It is due to direct excitation of the cells of the pancreas by a body provisionally called secretin (Starling and Baylis). This body is formed in the mucous membrane of the duodenum and jejunum and reaches the pancreas by the blood-stream. The acid splits off secretin from a precursor presecretin, which is present in rela- tively large amounts in the mucous membrane of the duodenum.—Ed.] No definite statement can be made as regards the quantity of pan- creatic juice excreted in twenty-four hours. This is due to the fact that the amount secreted varies in temporary and in permanent fistulas. Dogs with a temporary fistula excrete from 2.5 to 5 grams per kilo in the twenty-four hours, while dogs with a permanent fistula have been known to excrete twenty times as much. Great variations have also been ob- served in the composition of the secretion. It is a clear, colorless, very alkaline fluid, sticky and odorless, and contains a sufficient amount of albumin to become solid on boiling. The percentage of solids varies as much as the total quantity, and may be from 1.5 to 11.5 per cent. The percentage of organic substances fluctuates from 0.6 to 0.8 per cent. Zawadsky, who had an opportunity of analyzing the composition of normal human pancreatic juice (in a case of pancreatic fistula follow- ing removal of a tumor), obtained the following results : Water, 86.4 per cent.; solids, 13.59 per cent. ; organic matter, 13.25 per cent. ; inorganic matter, 0.34 per cent. Of the organic matter, 9.2 parts were proteid material and 0.83 part could be extracted with alcohol. [In a fistula of two and a half years' duration following drainage of a pan- creatic cyst in a girl aged nineteen years, the fluid contained 99.32 per cent, water and 0.68 per cent, solids ; and since it had practically no tryptic or lipolytic action, was not ordinary pancreatic juice. This case, investigated by Murray and Gies, is important in showing that it must not be assumed that a fistula left after operations on the pancreas is necessarily due to the escape of pancreatic fluid.—Ed.] The most important constituents of the pancreatic juice are three enzymes—namely, an amylolytic, a proteolytic, and a lipolytic enzyme. [Halliburton and Brodie have shown that pancreatic juice precipitates the caseinogen of milk, and Vernon has proved that, as suggested by Edkins, there is a rennet ferment in the pancreatic juice.—Ed.]](https://iiif.wellcomecollection.org/image/b21170010_0026.jp2/full/800%2C/0/default.jpg)
