Diseases of metabolism and of the blood : animal parasites, toxicology / ed. by Richard C. Cabot ... An authorized translation from "Die deutsche klinik" under the general editorial supervision of Julius L. Salinger, M. D. With one colored plate and fifty-eight illustrations in the text.

  • Richard Clarke Cabot
Date:
1906
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of metabolism and of the blood : animal parasites, toxicology / ed. by Richard C. Cabot ... An authorized translation from "Die deutsche klinik" under the general editorial supervision of Julius L. Salinger, M. D. With one colored plate and fifty-eight illustrations in the text. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    But also the negative results of many investigations which showed nor- mal or almost norma] al»sorption in such pathologic states—conditions in which with a certain degree of justice it might have been supposed that more serious disturbances were present—have given a basis of support for the dietetic treatment of such cases, and have shown the fallacy of many diet lists based upon erroneous ideas. 1 refer to the excellent monograph of Ad. Schmidt and J. Strassburger,1 in which the results of their researches in this subject are compiled, and I shall limit myself to mentioning a few researches. The mal-assimilation of food which Fr. Müller found in patients with stasis of bile is limited almost exclusively to fat. Midler found in the feces of his patients fat amounting to 87.4 per cent, (against 22 per cent, in the healthy). The loss in fat often amounted to 50 to 70 per cent, of the fat administered as food. The same decided decrease of fat absorption was afterward observed in occlusion of the pancreatic juice from the intestine without complications (Deucher).2 In a case of carcinoma of the head of the pancreas, in which no stasis of bile was present, only 17 per cent, of the fat introduced was absorbed; therefore, the simultaneous action of pancreatic juice and bile is necessary for a sufficient absorption of fat in man. On the other hand, it appears from the reports of investigations that neither bile nor pancreatic juice is necessary for the complete splitting up of fats in the intestinal canal. Not only the fatty stools of the jaundiced patient (Fr. Midler), but also (according to Deucher) the feces in occlusion of the pancreatic duct contain fat which is chiefly in a split-up form (up to 80 per cent.) ; therefore, Deucher teaches that we cannot count upon the absence of free fatty acids in the feces as evidence of disturbances in the pancreatic function. Predominance of free fatty acids, naturally, not at the cost of the neutral fats, but, on the contrary, at the expense of the soaps (Deucher), means pre- sumably a decrease or absence of the pancreatic juice secretion. By others3 in individual cases, a lessened fat splitting has also been ob- served in connection with occlusion of the pancreatic juice from the intes- tine. Volhard4 has shown that, although the decomposition of neutral fats is primarily the function of the pancreas, in cases of occlusion of the pan- creatic juice, fat splitting occurs not only through the action of bacteria, but also through the action of the gastric juice which also contains a fat splitting ferment. There is need of further investigations with due consideration of this factor. i Ad. Schmidt und •/. Strassburger, Die Faces des Menschen. Bonn, 1001. 2 Deucher, Stoffwechseluntersuchungen bei Verschluss des Ductus pancreaticus. Correspondenzbl. f. Schiceizer Aerzte, 1898, Nr. 11. 3 Fr. Müller, loc. cit., Weintraud, Die Bedeutung des quantitativen Stoffwechsel- versuches für die Diagnostik innerer Krankheiten, insbesondere von Pankreaserkrank- ungen. Die Heilkunde, 1898, Heft 2. 4 Volhard, Ueber das fettspalteude Ferment des Magens. Zeitschr. f. klin. Med., 1901, Bd. xliii, p. 397.