Lydia M. Dewitt 223
from that of the pancreatic cells is shown by the marked differ-
ences in their affinity for stains, especially for silver nitrate and
safranin. As has been shown by many experimenters, the islands
may be well preserved when the gland tissue is extremely atro-
phied, so that they do not seem to be subject to the same con-
ditions as pancreatic cells. Of especial importance is the fact
that islands have been found in some species independent or
practically independent of the pancreas. For these reasons we
certainly seem justified in the conclusion that the islands of Lan-
gerhans are independent organs with an independent function.
For over a century, cases of diabetes have been reported in
which the pancreas was diseased, and the tendency has been
constantly increasing to regard pancreatic disease as one, at
least, of the causes of diabetes. This tendency has been greatly
augmented since I 889, when Minkowski showed that in dogs
the removal of the pancreas gave rise to glycosuria and most
of the symptoms accompanying diabetes in man. Since then,
medical literature has abounded with clinical and pathological
reports as well as with chemical and experimental studies on the
relation betw-een the pancreas and sugar metabolism. After
lesions of the islands of Langerhans in association with
diabetes mellitus were described by Opie in I900, discussion has
been limited to the relation between sugar metabolism and the
islands of Langerhans. I do not intend to enter in detail
into the pathological reports, since my own work does not to
any extent deal with the clinical side of the question and since
pathologists are still at variance in their conclusions. Suffice
it to say that Opie, Weichselbaum and Stangl, Wright and Joslin,
Herzog, Ssobolew, and many others believe themselves justified
in accepting the theory that pancreatic diabetes is due to some
disturbance of the function of the areas of Langerhans, while
Hansemann, Gutmann, Reitmann, Karakaschew, Herxheimer,
Dieckhoff, Benda, and others contend that this theory does not
explain and can not be based upon the facts observed.
Recently Sauerbeck has collected from the literature most of
the published cases of diabetes in which the condition of the
islands xvas reported and has added to them a number of his