224 iforp/tology elud Physiology of Ar eas of Langerbalns
own cases. He states that II7 of the I57 cases of the series
show abnormal islands of Langerhans. In seven cases the
islands could not be found. In one, they were represented by
scar tissue. The changes described are as follows: (I) a
diminution in size and number; (2) qualitative changes, such
as hæemorrhage, fatty degeneration, acute and chronic inflam-
mation, simple atrophy, hydropic degeneration (Weichselbaum
and Stangl), sclerosis, and hyaline degeneration. If we reject as
too indeterminate the purely quantitative changes, we still have
98 of the I57 cases in which qualitative changes were observed.
Most of these changes have, however, in greater or less degree,
been reported in non-diabetic cases, and eleven cases have been
dlescribed by Dieckhoff, Hansemann, Litten, and Ziehl, in w-hich
the pancreas was entirely destroyed by suppuration or by car-
cinoma and yet no diabetes occurred, while non-diabetic cases
have been observed irli which no normal islands were found.
Whether it be that in the complexity of function of the human
organs, some other organ or tissue takes up the work of the areas
under certain conditions, whereas in other cases they fail to do
so, cannot be stated with any certainty. Several writers have
asserted an interrelation of function between the pancreas, the
liver, and the spleen, while Lorand has recently asserted that he
has proved by experiments on dogs a relation between the function
of the areas of Langerhans and the thyroid. He therefore states
that the areas of Langerhans secrete a substance which neu-
tralizes the poison produced by the thyroid and that diabetes
may result either from the increased functional activity of the
thyroid or from diminished activity of the areas of Langerhans.
However this may be, all that can be said in the present con-
dition of our knowledge is that the anatomo-pathologic investi-
gation of this question has not as yet led to any satisfactory
solution.
The announcement of the relation of the pancreas to sugar
metabolism gave an impetus to an investigation of this question
from the chemical point of view. Arnheim and Rosenbaum
asserted the presence of a glycolytic substance in pancreas, in
muscle, and in liver, the glycolysis being much increased if pancre-