Читать книгу Old Age Deferred. The causes of old age and its postponement by hygienic and therapeutic measures онлайн

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The pancreas, also, can only be examined by indirect evidences of its activity. A history of frequent or occasional epigastric colic, of large quantities of unformed shapeless stools of a yellow or yellow-gray color, containing undigested fat, together with loss of weight, will make us think of the possibility of disease of the pancreas. The most exact proof of such change can only be obtained by microscopical examination of the fæces.

Examination of the urine for sugar can also tell us whether there is disease of the pancreas, especially of those parts of the pancreas which constitute a ductless gland, independently of the rest of the viscus, namely, the islands of Langerhans.^[125]

As Mering and Minkowski^[126] first showed, every dog whose pancreas is extirpated invariably becomes diabetic, and this diabetes is similar to that of man. In many cases of diabetes changes in the pancreas have been found at autopsy; and although a good number of cases without any apparent change in the pancreas have been recorded, the cause of these has been revealed by an American author, Dr. Opie,^[127] then of the Johns Hopkins University in Baltimore. This author has found in a few cases of diabetes alterations in the islands of Langerhans in the pancreas. This fact has been confirmed by a good many authors, of whom I may mention Sobolew,^[128] Weichselbaum^[129] and Stengel, Sauerbeck, and others. As is invariably the case, the statements of these authorities have been attacked by others, as Hanseman, who have found no such changes in the islets in diabetes. We must, however, state here, that an apparently perfect anatomical condition of glandular structure after death need be no proof of a perfect secretory activity during life. Every epithelial formation, and the islands of Langerhans are of this nature, must furnish a secretion, and this flows in every gland only under a nervous stimulation. As Pawlow has shown, the pancreas secretes under nervous impulse. Therefore the findings of pathological anatomy cannot show us whether these glands have been secreting properly during life or not, especially in a nervous disease such as diabetes.