Pancreas

“ The pancreas also arises by localized bulging outwards of the intestinal lining—there being commonly three distinct rudiments in the embryo. In the Selachians the whitish compact pancreas of the adult opens into the intestine some little distance behind the opening of the bile duct, but in the Teleostomes it becomes involved in the liver outgrowth and mixed with its tissue, being frequently recognizable only by the study of microscopic sections. In the Dipnoans the pancreatic rudiment remains imbedded in the wall of the intestine: its duct is united with that of the liver. ”

“ When the pancreas is excised in an animal, or when it is destroyed in man by disease, grape-sugar appears in the urine. The gland is supposed to secrete a ferment, which, being absorbed into the portal circulation, breaks up a certain portion at least of the grape-sugar contained in the portal blood, and so prevents this overflowing into the circulation in general. The transplantation of a piece of living pancreas into the tissues of an animal, thus rendered artificially diabetic, is said to restore it to health. ”

“ So much attention and flirtation does the liver receive from the liver-persuaders that the pancreas ought to be very jealous. The pancreas excretes quite as much fluid into the duodenum as its larger neighbor, and is, therefore, no mean organ. And we need not wonder should we find the intestinal glands piqued at our over-attention to the liver, as they, in their work at the metamorphosis of digested food into blood, excrete two or three gallons of fluid in a day to the liver's two or three pints ”

“ The pancreas is a gland near the stomach; it secretes the juice known as pancreatic and pours it into the duodenum, or small intestine, which—some ten or fifteen feet in length, is folded about it. To prevent intestinal indigestion there must be an abundant flow of pancreatic juice, and this flow is stimulated by the vinegar in the salad we eat and other acids in our food. ”

“ It has been clearly proved that disease of, or removal of, certain groups of cells imbedded in the pancreas, known as the 'islands of Langerhans,' cause the appearance of sugar in the urine. And no doubt remains that many of the cases of diabetes are primarily disease of the pancreas. On the other hand, obesity may depend on the suspension of function of other glands. The removal of the sexual glands is commonly, though by no means invariably, followed by the laying on of fat. ”

“ The duodenum is not a U-shaped loop, but makes one together with the stomach; the pancreas lies between it and the stomach, and is more compact than the rabbit's. There is no separate pancreatic duct, but the bile duct runs through the pancreas, and receives a series of ducts from that gland as it does so. The ileum is shorter, there is no sacculus rotundus, and the large intestine has no caecum, none of the characteristic sacculations of the rabbit's colon, and does not loop back to the stomach before the rectum section commences. ”

“ Position and Structure of the Pancreas.—The most important digestive gland in the human body is the pancreas. The gland is a rather diffuse structure; its duct empties by a common opening with the bile duct into the small intestine, a short distance below the pylorus. In internal structure, the pancreas resembles the salivary glands.
Appearance of milk under the microscope, showing the natural grouping of the fat globules. In the circle a single group is highly magnified. Milk is one form of an emulsion. ”

“ The discharge of the secretions of the pancreas and liver, although more active during and after feeding, is practically constant, and so insures in an admirable manner that the curve on which the efficiency of the trap depends shall be constantly kept full not only with fluid, but, as I would suggest, antiseptic fluid. ”

“ The pancreas has been most extensively studied by Birch-Hirschfeld, who examined seventy-three syphilitic foetuses. In thirteen of them he [p. 307] found enlargement of the pancreas with increased weight and density, proliferation of connective tissue, and in some cases compression—almost obliteration—of the lobules, with atrophy and fatty degeneration of their epithelium.191
191 Klebs discovered a gumma in the pancreas of a six-months' foetus. ”

“ The same is true of the kidneys and of the heart, and the factor of safety in the case of the pancreas explains why we do not all have diabetes. Very few people have a normal pancreas, because inflammations in organs near the pancreas are fairly common; for instance, inflammation of the gallbladder, and very frequently the pancreas is involved in such inflammation. However, the number of persons with known gallbladder disease who develop diabetes, is not appreciably greater than that of persons without any evidence of such inflammations. ”

“ Even in aged persons we have noted easier digestion and the disappearance of digestive trouble after two or three tablets of the extract of pancreas taken immediately after dinner and supper. In cases of liver and gall-stone troubles, where previously there was a considerable loss of bodily weight, in nearly every case after pancreatic treatment there was no more falling off in the weight, and in some instances we have even found a considerable increase in weight. ”

“ The pancreatic juice is secreted by the pancreas, an elongated organ situated just behind the stomach, and its purpose is to act upon the fatty portions of the food and to render them possible of absorption from the intestines along with the other parts of the food nourishment. ”

“ Not only is this the case with the secretion from the glands surrounding the mouth, but the pancreas which is concerned in a later stage of digestion is a gland so similar to the salivary glands that in ordinary cookery both are dressed and served as ‘sweetbreads;’ the ‘pancreatic juice’ is a liquid closely resembling saliva, and contains a similar diastase, or substance that converts starch into dextrin, and from dextrin to sugar. ”

“ From the intimate anatomical relation of the pancreas to the solar plexus it is easy to understand how disease of the gland may give rise to alterations in the nerve-structure, either by direct pressure or by the extension of inflammation along the nerve-fibres connecting the gland with the ganglia; and these alterations in time produce diabetes. In the instances in which diabetes is the primary affection the condition of the pancreas, as proved by post-mortem section, is usually one of simple or fatty atrophy ”

“ Comparative Anatomy.—In the Acrania (Amphioxus) no representative of a pancreas has been found, but in the Cyclostomata (hags and lampreys) there is a small lobular gland opening into the bile duct which probably represents it. In the Elasmobranchs (sharks and rays) there is a definite compact pancreas of considerable size. In the Teleostomi, which include the true bony fish (Teleostei) , the sturgeon and Polyterus, the pancreas is sometimes a compact gland and sometimes diffuse between the layers of the mesentery; at other times it is so surrounded by the liver as to be difficult to find. ”

“ The pancreas is no longer taken to be only a sort of salivary gland out of place: over and above the secretion that it pours into the intestines, it has an "internal secretion," a constituent of the blood: it belongs not only to the digestive system, but also, like the thyroid gland and the suprarenal capsules, to the whole chemistry of the blood and the tissues. So far has physiology come, unaided by anatomy, from the fantastic notions of Lindanus and the men of his time: and has come every inch of the way by the help of experiments on animals. ”

“ We are at liberty, however, to suppose that the fat on the one hand is of importance for the inhibition of the gastric glands, and the alkalinity on the other for the restraint of the pancreas. Thus the gastric glands and the pancreas, notwithstanding the presence of excitants, are maintained by milk at a certain but not too high degree of activity, a matter which is in every way desirable in consideration of the easy digestibility of its constituents. ”

“ The diet must be simple and digestible, and if an arrest of the pancreatic secretion be indicated by the appearance of fat in the stools, an effort should be made to supply the deficiency. For this purpose pancreatin, prepared by precipitation by alcohol from a watery extract of a calf's or pig's pancreas, may be used.1 The pancreatin may be given in doses of from five to fifteen grains, in the form of a pill or in capsules, and at an interval of two hours after food is taken, or the same quantity of pancreatin may be added to the food a few moments before it is eaten. ”

“ Diseases of the pancreas seriously embarrass digestion in the intestine. Lesions of this organ, as catarrh of the duct, cancer, fatty degeneration, etc., may result in impaired emulsification of fats, fatty diarrhoea, and wasting.
Intestinal indigestion accompanies hyperæmia and catarrh of the intestinal mucous membrane, diseases of the heart, lungs, and liver, and all other causes which impede portal circulation. ”

“ But the fact that the wall of the intestine produces secretion, which carried by the blood causes the pancreas to secrete, shows that a particular gland is not necessary. There is nothing improbable in supposing that a tissue stimulated to excessive growth by external irritation would give off special substances to the blood. ”

“ Meat, when taken in large quantities, can thus cause the pancreas considerable overwork, which, in the long run, as is well-known, may cause trouble, as is shown by the fact learned from observation, that diabetes develops generally in meat eaters. Even in dogs an abundant meat diet can produce spontaneous diabetes, a 320fact we have already published. Diabetes may not only be due to the changes in the pancreas, but also as we have shown [278] to those in the thyroid gland, consequent upon such nourishment. ”

“ This passes to the pancreas and causes increased secretion from that gland. It is probable that the pancreas in its turn also secretes something which activates a ferment in the muscles. It is evident therefore that the connexion between the different glands of the body is a very complicated one and that the effects of a drug which acts upon any one of them may be of a very far-reaching character. It is by no means improbable that all glands have a double or even triple function, and that sometimes the external may be even less important than the internal secretion. ”

“ When the stomach has done its work, its contents in a semi-fluid state pass into the small intestine, and mix there with the bile, the secretions from the intestines themselves, and with those of the large gland, the pancreas (in culinary language known as the sweetbread) , which seems to have the special power of dissolving fatty matters. ”

“ These observations place the development of the human pancreas in line with the triple pancreatic outgrowths, two ventral and one dorsal characteristic of the majority of the lower vertebrates, which have been hitherto carefully examined. ”

“ Pancreas, pan′krē-as, n. a conglomerate gland, lying transversely across the posterior wall of the abdomen, secreting the pancreatic juice which pours with the bile into the digestive system.—adj. Pancreat′ic, pertaining to the pancreas.—ns. Pan′creatin, the pancreatic juice; Pancreatīt′is, inflammation of the pancreas. [Gr. pas, pan, all, kreas, flesh.] ”

“ The control of sugar mobilization from the liver, where it is stored as glycogen or animal starch, is divided between the pancreas and the adrenals, the pancreas acting as the brake, the adrenals as the accelerator of the mechanism. Adrenal and pancreas are therefore direct antagonists, the pans of the scale which represents sugar equilibrium in the organism. Diabetes may be regarded as a disturbance of the adrenal-pancreas balance, assisted by events which produce adrenal overwork like great or prolonged emotion, or by strain of the pancreas, effected by over-eating for example. ”

“ The part describing morbid changes in the pancreas is perhaps the best section of the book. Its defect is a want of that familiarity with diseased structures which can only be acquired in the post-mortem room. Craigie was physician to the Edinburgh Infirmary, but was more of a writer than of an observer. ”

“ The secretion of the pancreas also contains a very active ferment, which, on entering the bowel, meets and mixes with another ferment four times as powerful as gastric juice, which completes the digestion of the proteids.
Meantime, the secretions of Lieberkühn's glands (of which there are immense numbers in the small intestine) are further aiding the digestion of the chyme, while the liver (the largest and most important gland in the body) sends its ferments, and the gall-bladder its bile, which further emulsifies the fatty acids and glycerin until they are ready to be absorbed. ”

“ As soon as the food is reduced to a state of fluidity, the pyloric orifice of the stomach is unclosed, and it is thrust onwards through the alimentary canal, receiving in the duodenum the secretions of the liver and pancreas, after which it yields to the lacteals its nutrient portion, and the residuum is expelled from the body. ”

“ I can lawfully state that I think their liver tests weak, the pancreas appears not to be functioning well in terms of handling meat digestion, that the kidney is having a hard time of it. I can say I see a lump sticking out of their body when one is obviously sticking out of their body; I can not say that lump is cancerous but I can state that the cells in that lump test overly strong and that if I myself had a mass of growing cells testing overly strong and if I believed in the standard medical model, then I would be rushing my overly strong testing cells to an oncologist. ”