Russell M. Wilder

III. APPLICATION IN INTERNAL MEDICINE

Pancreatic preparations may be valuable theoretically both in the treatment of conditions resulting from a failure of the external pancreatic secretions, and in the treatment of diabetes resulting from a failure of the internal pancreatic secretion. PANCREATIC DIGESTIVE FERMENTS In digestive disturbances attributable to diminished or absent pancreatic activity, the need for the oral administration of pancreatic ferments is problematic and the utility of pancreatin, desiccated pancreas and analogous preparations is doubtful. The use of these cannot be entirely condemned, because such condemnation would be contrary to the experience of many excellent clinicians. However, clinical reports are conflicting, and the best experimental evidence indicates that such preparations have little or no value. For instance, dogs with pancreatic fistulas absorb fat no better when licking their fistulas than they do when muzzled and not allowed to lick any ferment. Similarly, the administration of pancreatic preparations in completely depancreated dogs in no