Fatal Effect of the Total Loss of Pancreatic Juice. ∗

Abstract

While certain of the earlier physiologists, notably Pawlow, had noted various deleterious effects from chronic pancreatic fistula in animals, these were commonly ascribed to the disturbance in digestion resulting from the absence of an important digestive juice in the alimentary tract. Elman and McCaughan 1 were the first to clearly demonstrate that these adverse symptoms were due to the removal of some necessary substance from the body and its excretion in the pancreatic juice. By an improved type of fistula which permitted greater quantities of pancreatic juice to escape than had been obtained by former workers, they found that death resulted in the dog in from 7 to 8 days when pancreatic juice in amounts of from 150 to 400 cc. was lost per day. Confirming these findings Gamble and McIver 2 reported that 2 dogs provided with pancreatic fistulae of the Pawlow type died in 15 to 42 days respectively and concluded that death was due to dehydration and acidosis resulting from the large loss of Na and CI in the pancreatic secretion. Both Gamble and Elman later found that life could be prolonged by simply restoring the inorganic elements and water that were lost.

The present experiments were in progress when the paper by Elman and McCaughan appeared and they confirm their findings in all essential respects. Animals were provided with pancreatic fistulae of the type described in the preceding paper. They were given 2000 cc. of Ringer's solution intravenously for the first 5 days after operation at which time the fistula was secreting profusely and the dog was in good condition. From 500 to 1500 cc. of pancreatic juice were obtained in 24 hours, the very large amounts being doubtless due to the fact that all of the pancreatic ducts had their outlets into the duodenal sac undisturbed.