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STUDIES IN PANCREATIC DISEASE

STUDIES IN PANCREATIC DISEASE Abstract PART I.—DUODENAL CONTENT ANALYSES AS AN INDEX OF DISEASE, AND FUNCTIONAL ACTIVITY OF THE PANCREAS A reliable method for ascertaining the functional activity of the pancreas, has been eagerly sought for the last few decades, in fact since the time that Kuntzman, Richard Bright and Claude Bernard first called attention to this gland as a possible focus of disease.The large variety of tests offered, some ten to twenty in number, is in itself testimony to the fact that no one test has met the mark or has satisfied the rigorous requirements of both pathologist and clinician. These tests fall into three groups: tests of the external secretion of the pancreas, usually carried out on the stool (Fuld-Gross), the urine (Wolgemuth), or gastric contents (Volhard oil test) ; tests of the internal secretion, consisting of tests for glycosuria, the Cammidge reaction, the Loewi pupillary dilatation test, etc.; and finally metab References 1. Frank: Arch. f. Verdauungskr. , 1912, xviii, 121.Crossref 2. Albu: Samml. Zwangloser Abhand. a. d. Gebiet. d. Verdauungskr. u. Stoffwechselskr. , 1911, iii, 1. 3. Werzberg: Arch. f. Verdauungskr. , 1911, xvii, 533.Crossref 4. Gross: Ergebn. d. wissensch. Med. , 1911, ii, 403. 5. Sladden: Quart. Jour. Med. , 1914, vii, 455. 6. Crohn : Proc. Eighth Internat. Congress Applied Chem. , 1912 7. Am. Jour. Med. Sc. , 1913, cxlv, 393. 8. Bondi: Arch. f. Verdauungskr. , 1913, xix, 692.Crossref 9. Einhorn: Deutsch. med. Wchnschr. , 1910, xxxvi, 1519Crossref 10. Jour. Am. Med. Assn. , 1910, lv, 6. 11. Junghans: Zentralbl. f. d. ges. Physiol. u. Path. d. Stoffwechs. , 1911, vi, 49. 12. Von Barth Wehrenalp: Internat. Beitr. z. Path. u. Therap. d. Ernährungsstör ung. , 1910, i, 530. 13. Einhorn and Rosenbloom: The Archives Int. Med. , 1910, vi, 666.Crossref 14. Hess: Am. Jour. Dis. Child. , 1912, iv, 205. 15. Hess: Am. Jour. Dis. Child. , 1913, v, 268. 16. Kleinberger: Berl. klin. Wchnschr. , 1909, xlvi, 2329. 17. Friedman, G. A.: Med. Rec., New York , 1912, lxxxi, 355. 18. Chace and Myers: The Archives Int. Med. , 1913, xii, 168.Crossref 19. Bondi and Solomon: Wien. med. Wchnschr. , 1913, lxiii, 1722. 20. Einhorn: Am. Jour. Med. Sc. , 1914, cxlviii, 490.Crossref 21. Orlowski: Ztschr. klin. Med. , 1912, lxxvi, 460. 22. Lifschütz: Arch. f. Verdauungskr. , 1913, xix, 562. 23. Matko: Arch. f. Verdauungskr. , 1913, xix, 663.Crossref 24. Pratt: Am. Jour. Med. Sc. , 1912, cxliii, 314. 25. Tileston : Trans. Assn. Am. Phys. , 1911, xxvi, 513 26. The Archives Int. Med. , 1912, ix, 525.Crossref 27. Bernard, Claude: Memories sur le pancreas, 1856. 28. Pawlow: Quoted from Oser, in Nothnagel's Encyclopedia of Practical Medicine, 1903. 29. Von Mering and Minkowski: Arch. exper. Path. u. Pharmakol. , 1899, xxvi, 371. 30. Minkowski: Arch. exper. u. Pharmakol. , 1905, liii, 331.Crossref 31. Abelmann: Ausnutzung der Nährungstoffe nach Pankreas-Extirpation . Dorpat, 1890. 32. Sandmeyer : Ztschr. f. Biol. , 1894, xxxi, 12. 33. Hedon and Ville: Compte rend. Soc. de biol. , 1892, p. 308. 34. Harley: Jour. Path. and Bacteriol. , 1895, iii, 245. 35. Rosenberg: Arch. f. d. ges. Physiol. (Pfluger's) , 1898, lxx, 371.Crossref 36. Zunz and Mayer: Ref. Jahresb. u. d. Fortschr. d. Thierchem. (Maly's) , 1905, xxxv, 489. 37. Lombroso: Arch. f. d. ges. Physiol. (Pfluger's) , 1906, cxii, 531.Crossref 38. Hess: Arch. f. d. ges. Physiol. (Pfluger's) , 1907, cxviii, 536.Crossref 39. Sinn: Dissert. Marburg, 1907, p. 29. 40. Lombroso: Arch. f. exper. Path. u. Therap. , 1908-9, lx, 99.Crossref 41. Burckhardt: Arch. f. exper. Path. u. Pharmakol. , 1908, lviii, 251.Crossref 42. Fleckseder : Arch. f. exper. u. Pharmakol. , 1909, lix, 407. 43. Niemann : Ztschr. f. exper. Path. u. Therap. , 1909, v, 466.Crossref 44. Jansen: Ztschr. f. physiol. Chem. , 1911, lxxii, 158.Crossref 45. Brugsch : Ztschr. f. exper. Path. u. Therap. , 1909, vi, 326.Crossref 46. Pratt, Lamson and Marks: Tr. Assn. Am. Phys. , 1909, xxiv, 266. 47. Benedict and Pratt: Jour. Biol. Chem. , 1913, xv, 1. 48. In studying fat and nitrogen metabolism in pancreatic disease, it is essential to restrict oneself to cases in which the intake of food was carefully analyzed, as well as the output of feces. Only in this way can conclusions be reached, since analyses merely of stools, or general observations on the character, number, or consistency of the movements, without taking into consideration the nutritive value of the diet, are fallacious. 49. Kuntzmann: Jour. d. Pract. Heilk. , 1824, lix, 45. 50. Bright, Richard: Medico-Chirurg. Trans. , 1833, xviii, 1. 51. Fles: Holland Arch. , 1864, ii, 187 52. Robson and Cammidge, "The Pancreas, Its Surgery and Pathology," 1907 53. Le Nobel: Jahresb. u. d. Fortschr. d. Thierchem. (Maly's) , 1886, p. 449. 54. Delfino: Deutsche Ztschr. f. Chir. , 1913, cxxi, 280.Crossref 55. Weintraud: Die Heilkunde , 1898, iii, 67. 56. Brugsch and Konig: Berl. klin. Wchnschr. , 1905, xlii, 1605. 57. Gigon: Ztschr. f. klin. Med. , 1907, lxiii, 420. 58. Barbour : The Archives Int. Med. , 1911, viii, 662.Crossref 59. Ehrmann and Krüspe: Ztschr. f. klin. Med. , 1913, lxxviii, 122. 60. Deucher: Cor.-Bl. f. schweiz. Aerzte , 1898, xxviii, 321. 61. Meyer, E.: Ztschr. f. exper. Path. u. therap. , 1906, iii, 58.Crossref 62. Wynhausen: Berl. klin. Wchnschr. , 1909, xlvi, 1406. 63. Brugsch: Ztschr. f. klin. Med. , 1905, lviii, 518. 64. Schmidt and Strassburger: Die Feces des Menschen , Berlin, 1905. 65. Müller, Fr.: Ztschr. f. klin. Med. , 1887, xii, 45. 66. Bondi, S., and Bondi, J.: Ztschr. f. exper. Path. u. Therap. , 1909, vi, 254.Crossref 67. Von Noorden: Handb. d. Path. d. Stoffwechsel. , 1906. 68. Gross, O.: Deutsch. Arch. f. klin. Med. , 1912, cvii, 106. 69. Kumagawa-Suto: Biochem. Ztschr. , 1908, viii, 252. 70. It might be suggested in this case, that a patent accessory duct of Santorini supplied ferments to the intestine. Careful dissection in six cases of obstruction of the duct of Wirsung failed to show any instance of a patent accessory duct. Nor have any of the observers of pancreatic disease noted a patent accessory duct, except Tileston23 who once found it. However, the duodenal tube, lying deep in the intestine, would not differentiate between main and accessory ducts; if ferments are being secreted it would discover them. When no ferments are found, it is safe to assume that all ducts are closed, as the Santorini duct in man opens with, or within a centimeter or two of the Vaterian papilla. At autopsy the accessory duct has often been seen, but never patent through to the lumen of the intestine. 71. Umber and Brugsch: Arch. f. exper. Path. u. Pharmakol. , 1906, lv, 164.Crossref 72. Franke: Arch. f. klin. Chir. , 1901, lxiv, 364. 73. Adler and Milchner: Berl. klin. Wchnschr. , 1908, xlv, 1487. 74. Walker: Med. Chir. Tr. , 1889, lxxii, 257. 75. Glaessner and Sigel: Berl. klin. Wchnschr. , 1904, xli, 440. 76. Keuthe: Berl. klin. Wchnschr. , 1909, xlvi, 47. 77. Hirschfeld: Ztschr. f. klin. Med. , 1891, xix, 294. 78. Fitz: Tr. Congr. Am. Phys. and Surg. , 1903, vi, 36. 79. Deaver: Jour. Am. Med. Assn. , 1911, lvi, 1079.Crossref 80. Garrod and Hurtley: Quart. Jour. Med. , 1912, vi, 242. 81. Bramwell: Quoted from Robson and Cammidge, The Pancreas, Its Surgery and Pathology, 1907. 82. Bittorf: Deutsch. med. Wchnschr. , 1912, xxxviii, 1034.Crossref 83. Whipple: Bull. Johns Hopkins Hosp. , 1907, xviii, 382. 84. Salomon: Berl. klin. Wchnschr. , 1902, xxxix, 45. 85. Ehrmann: Ztschr. f. klin. Med. , 1909-10, lxix, 319. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

STUDIES IN PANCREATIC DISEASE

Archives of Internal Medicine , Volume XV (4) – Apr 1, 1915

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Publisher
American Medical Association
Copyright
Copyright © 1915 American Medical Association. All Rights Reserved.
ISSN
0730-188X
DOI
10.1001/archinte.1915.00070220083009
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Abstract

Abstract PART I.—DUODENAL CONTENT ANALYSES AS AN INDEX OF DISEASE, AND FUNCTIONAL ACTIVITY OF THE PANCREAS A reliable method for ascertaining the functional activity of the pancreas, has been eagerly sought for the last few decades, in fact since the time that Kuntzman, Richard Bright and Claude Bernard first called attention to this gland as a possible focus of disease.The large variety of tests offered, some ten to twenty in number, is in itself testimony to the fact that no one test has met the mark or has satisfied the rigorous requirements of both pathologist and clinician. These tests fall into three groups: tests of the external secretion of the pancreas, usually carried out on the stool (Fuld-Gross), the urine (Wolgemuth), or gastric contents (Volhard oil test) ; tests of the internal secretion, consisting of tests for glycosuria, the Cammidge reaction, the Loewi pupillary dilatation test, etc.; and finally metab References 1. Frank: Arch. f. Verdauungskr. , 1912, xviii, 121.Crossref 2. Albu: Samml. Zwangloser Abhand. a. d. Gebiet. d. Verdauungskr. u. Stoffwechselskr. , 1911, iii, 1. 3. Werzberg: Arch. f. Verdauungskr. , 1911, xvii, 533.Crossref 4. Gross: Ergebn. d. wissensch. Med. , 1911, ii, 403. 5. Sladden: Quart. Jour. Med. , 1914, vii, 455. 6. Crohn : Proc. Eighth Internat. Congress Applied Chem. , 1912 7. Am. Jour. Med. Sc. , 1913, cxlv, 393. 8. Bondi: Arch. f. Verdauungskr. , 1913, xix, 692.Crossref 9. Einhorn: Deutsch. med. Wchnschr. , 1910, xxxvi, 1519Crossref 10. Jour. Am. Med. Assn. , 1910, lv, 6. 11. Junghans: Zentralbl. f. d. ges. Physiol. u. Path. d. Stoffwechs. , 1911, vi, 49. 12. Von Barth Wehrenalp: Internat. Beitr. z. Path. u. Therap. d. Ernährungsstör ung. , 1910, i, 530. 13. Einhorn and Rosenbloom: The Archives Int. Med. , 1910, vi, 666.Crossref 14. Hess: Am. Jour. Dis. Child. , 1912, iv, 205. 15. Hess: Am. Jour. Dis. Child. , 1913, v, 268. 16. Kleinberger: Berl. klin. Wchnschr. , 1909, xlvi, 2329. 17. Friedman, G. A.: Med. Rec., New York , 1912, lxxxi, 355. 18. Chace and Myers: The Archives Int. Med. , 1913, xii, 168.Crossref 19. Bondi and Solomon: Wien. med. Wchnschr. , 1913, lxiii, 1722. 20. Einhorn: Am. Jour. Med. Sc. , 1914, cxlviii, 490.Crossref 21. Orlowski: Ztschr. klin. Med. , 1912, lxxvi, 460. 22. Lifschütz: Arch. f. Verdauungskr. , 1913, xix, 562. 23. Matko: Arch. f. Verdauungskr. , 1913, xix, 663.Crossref 24. Pratt: Am. Jour. Med. Sc. , 1912, cxliii, 314. 25. Tileston : Trans. Assn. Am. Phys. , 1911, xxvi, 513 26. The Archives Int. Med. , 1912, ix, 525.Crossref 27. Bernard, Claude: Memories sur le pancreas, 1856. 28. Pawlow: Quoted from Oser, in Nothnagel's Encyclopedia of Practical Medicine, 1903. 29. Von Mering and Minkowski: Arch. exper. Path. u. Pharmakol. , 1899, xxvi, 371. 30. Minkowski: Arch. exper. u. Pharmakol. , 1905, liii, 331.Crossref 31. Abelmann: Ausnutzung der Nährungstoffe nach Pankreas-Extirpation . Dorpat, 1890. 32. Sandmeyer : Ztschr. f. Biol. , 1894, xxxi, 12. 33. Hedon and Ville: Compte rend. Soc. de biol. , 1892, p. 308. 34. Harley: Jour. Path. and Bacteriol. , 1895, iii, 245. 35. Rosenberg: Arch. f. d. ges. Physiol. (Pfluger's) , 1898, lxx, 371.Crossref 36. Zunz and Mayer: Ref. Jahresb. u. d. Fortschr. d. Thierchem. (Maly's) , 1905, xxxv, 489. 37. Lombroso: Arch. f. d. ges. Physiol. (Pfluger's) , 1906, cxii, 531.Crossref 38. Hess: Arch. f. d. ges. Physiol. (Pfluger's) , 1907, cxviii, 536.Crossref 39. Sinn: Dissert. Marburg, 1907, p. 29. 40. Lombroso: Arch. f. exper. Path. u. Therap. , 1908-9, lx, 99.Crossref 41. Burckhardt: Arch. f. exper. Path. u. Pharmakol. , 1908, lviii, 251.Crossref 42. Fleckseder : Arch. f. exper. u. Pharmakol. , 1909, lix, 407. 43. Niemann : Ztschr. f. exper. Path. u. Therap. , 1909, v, 466.Crossref 44. Jansen: Ztschr. f. physiol. Chem. , 1911, lxxii, 158.Crossref 45. Brugsch : Ztschr. f. exper. Path. u. Therap. , 1909, vi, 326.Crossref 46. Pratt, Lamson and Marks: Tr. Assn. Am. Phys. , 1909, xxiv, 266. 47. Benedict and Pratt: Jour. Biol. Chem. , 1913, xv, 1. 48. In studying fat and nitrogen metabolism in pancreatic disease, it is essential to restrict oneself to cases in which the intake of food was carefully analyzed, as well as the output of feces. Only in this way can conclusions be reached, since analyses merely of stools, or general observations on the character, number, or consistency of the movements, without taking into consideration the nutritive value of the diet, are fallacious. 49. Kuntzmann: Jour. d. Pract. Heilk. , 1824, lix, 45. 50. Bright, Richard: Medico-Chirurg. Trans. , 1833, xviii, 1. 51. Fles: Holland Arch. , 1864, ii, 187 52. Robson and Cammidge, "The Pancreas, Its Surgery and Pathology," 1907 53. Le Nobel: Jahresb. u. d. Fortschr. d. Thierchem. (Maly's) , 1886, p. 449. 54. Delfino: Deutsche Ztschr. f. Chir. , 1913, cxxi, 280.Crossref 55. Weintraud: Die Heilkunde , 1898, iii, 67. 56. Brugsch and Konig: Berl. klin. Wchnschr. , 1905, xlii, 1605. 57. Gigon: Ztschr. f. klin. Med. , 1907, lxiii, 420. 58. Barbour : The Archives Int. Med. , 1911, viii, 662.Crossref 59. Ehrmann and Krüspe: Ztschr. f. klin. Med. , 1913, lxxviii, 122. 60. Deucher: Cor.-Bl. f. schweiz. Aerzte , 1898, xxviii, 321. 61. Meyer, E.: Ztschr. f. exper. Path. u. therap. , 1906, iii, 58.Crossref 62. Wynhausen: Berl. klin. Wchnschr. , 1909, xlvi, 1406. 63. Brugsch: Ztschr. f. klin. Med. , 1905, lviii, 518. 64. Schmidt and Strassburger: Die Feces des Menschen , Berlin, 1905. 65. Müller, Fr.: Ztschr. f. klin. Med. , 1887, xii, 45. 66. Bondi, S., and Bondi, J.: Ztschr. f. exper. Path. u. Therap. , 1909, vi, 254.Crossref 67. Von Noorden: Handb. d. Path. d. Stoffwechsel. , 1906. 68. Gross, O.: Deutsch. Arch. f. klin. Med. , 1912, cvii, 106. 69. Kumagawa-Suto: Biochem. Ztschr. , 1908, viii, 252. 70. It might be suggested in this case, that a patent accessory duct of Santorini supplied ferments to the intestine. Careful dissection in six cases of obstruction of the duct of Wirsung failed to show any instance of a patent accessory duct. Nor have any of the observers of pancreatic disease noted a patent accessory duct, except Tileston23 who once found it. However, the duodenal tube, lying deep in the intestine, would not differentiate between main and accessory ducts; if ferments are being secreted it would discover them. When no ferments are found, it is safe to assume that all ducts are closed, as the Santorini duct in man opens with, or within a centimeter or two of the Vaterian papilla. At autopsy the accessory duct has often been seen, but never patent through to the lumen of the intestine. 71. Umber and Brugsch: Arch. f. exper. Path. u. Pharmakol. , 1906, lv, 164.Crossref 72. Franke: Arch. f. klin. Chir. , 1901, lxiv, 364. 73. Adler and Milchner: Berl. klin. Wchnschr. , 1908, xlv, 1487. 74. Walker: Med. Chir. Tr. , 1889, lxxii, 257. 75. Glaessner and Sigel: Berl. klin. Wchnschr. , 1904, xli, 440. 76. Keuthe: Berl. klin. Wchnschr. , 1909, xlvi, 47. 77. Hirschfeld: Ztschr. f. klin. Med. , 1891, xix, 294. 78. Fitz: Tr. Congr. Am. Phys. and Surg. , 1903, vi, 36. 79. Deaver: Jour. Am. Med. Assn. , 1911, lvi, 1079.Crossref 80. Garrod and Hurtley: Quart. Jour. Med. , 1912, vi, 242. 81. Bramwell: Quoted from Robson and Cammidge, The Pancreas, Its Surgery and Pathology, 1907. 82. Bittorf: Deutsch. med. Wchnschr. , 1912, xxxviii, 1034.Crossref 83. Whipple: Bull. Johns Hopkins Hosp. , 1907, xviii, 382. 84. Salomon: Berl. klin. Wchnschr. , 1902, xxxix, 45. 85. Ehrmann: Ztschr. f. klin. Med. , 1909-10, lxix, 319.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Apr 1, 1915

References

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