Results of an examination, macro scopical and microscopical, of the pan creas in 23 consecutive eases of diabetes mellitus. In S eases the pancreas was found to present a normal appearance both macroscopically and microscopic ally; and in 4 more there was atrophy, but not more than could be accounted for by the general wasting. In 5 cases there was atrophy more or less marked, and out of proportion to the general wasting: and in one of these the atrophy of the gland was so extreme that the pancreas weighed less than one-fourth ounee. In 4 cases cirrhosis of the pan creas was present, and in 2 of these the changes were marked. ln one case cancer of the pancreas was present, and in one the gland had undergone ex tensive fatty degeneration.
Results of the investigation of 54 cases of diabetes. In 40 of these the pancreas was found to be diseased, and in 36 the lesion was a simple atrophy. In 3 others fibrous induration was present, and in 1 ease the pancreas was cystic. In S cases out of the 54 the pancreas was normal, and in 6 there was no record as to the state of the gland.
The atrophy of the pancreas in dia betes differs from the simple atrophy accompanying general wasting in the fact that in the diabetic pancreas the stroma of the gland is not only not wasted, but the pancreas shows signs of an interstitial inflammation, and the stroma occupies spaces left by the atro phy of the parenchyma of the gland. Hansemann (Med. Chronicle, May, '97).
in 70 per cent. of diabetic patients some alterations in the pancreas were found. Of special interest in this con nection is a lipoinatosis of the pancreas, which may exist either in connection with the general excess of fat, or, on the other hand, may be found in lean subjects. Hansemann (Med. News, Jan. 22, '9S).
Diabetes may appear even when the pancreas is not organically, but only functionally, affected. Zaccharin and Polyakoff (Berliner klin. Wadi., vol. xxxv, p. 237, '9S).
Pancreatic diabetes is always grave. In view of data recently furnished by experimental pathology, there is no possible doubt as to the pathogenesis of the diabetes in this case: it is evidently due to the suppression of the secretions of the pancrea.
Diabetes never fails to appear after complete removal of the pancreas, if the animals live a sufficient time after the operation. This statement is founded on fifty-five experiments made on dogs. Minkowski (Berliner klin. Woch., 1092, No. 26, '92).
Coincidence of disease of pancreas and diabetes occurs more frequently than diabetes alone or pancreatic disease alone, and oftener than these two com bined. Commonest disease of pancreas
found in diabetes is an atrophy which differs from atrophy as the result of diabetes or of cachexias; comparable with certain forms of contracted kidney. Hansemann (Zeit. f. klin. Med., B. 26, '95).
Acute diabetes due to cancer of pan creas. Symptoms on admission simu lated those of cirrhosis of liver. Dresch feld (Med. Chronicle, Apr., '95).
Extirpation of pancreas of two dogs, leaving 'A, to 3/5 of organ; animals be came diabetic: one 4 and the other 13 months after. Sandmeyer (Zeit. f. Biol., B. 31, p. 12, '95).
Eels survived operation of removal of pancreas 7 to 12 days; 7 out of 11 showed no sugar in urine; 2 of then) did. Former, perhaps, retained pan , ereatic remnants. Caparelli (Archives ItaHennes de Biol., vol. xxi, p. 390, '95).
Extirpation of pancreas of 19 ducks and 5 carnivorous birds; 4 ducks showed slight glycosuria; 3 carnivorous birds manifestly glycosuric until death. Wein traub (Archiv f. experimentelle Path. u. Pharm., B. 34, p. 30S, '95).
The existence of pancreatic diabetes is established, but disease of the pan creas does not necessarily cause diabetes. Of 29 cases from the Massachusetts Gen eral Hospital that showed lesions of the pancreas, glycosuria was found in but 2, although in 12 cases there were no records of tests for sugar. Fatty stools are usually absent in cases of diabetes, and there is no record of their occurrence in 166 cases treated in the Massachusetts Hospital. R. H. Fitz (Yale 'Afed. Jour., Mar., '98).
In the cases where the lesion of the pancreas is a minor one (slight indura tion, slight atrophy, etc.) it is not sary to regard this slight lesion as the cause of the diabetes, for this disease is often accompanied by a generalized en darteritis,—a cause of sclerosis; or some times the diabetic cachexia engenders fatty degeiaerations. Contrary to the opinion held about half a century ago, experimental physiology has demon strated that hepatic lesions are not a cause of true diabetes. They may, at most, cause an alimentary glycosuria.
The mild form of diabetes of the fleshy is purely of hepatic origin, the cells of the liver being only affected. In con sequence of an anatomical or chemical change. as yet not known, they have lost their glycogenic power. Seegen (Zeit. f. klin. Med.. vol. xiii, p. 207, '89).