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Impaired Health Its Cause And Cure by J. H Tilden, M.D.

I. DISEASES OF THE PANCREAS

   When speaking of derangements of the pancreas, we necessarily, in this connection, think of digestion of the starches. If the mouthing of food is neglected, the whole work of digesting the starches falls on the alkaline secretions of the intestine. The pancreas stands at the head of this secretion. When there is difficulty in taking care of fat, we also think of a deranged secretion of the pancreas. The indication of deranged functioning of the pancreas is a changed appearance of the character of the stools. There is an excess of fat, which in some cases runs very high--even to one hundred per cent of the intake. The pancreatic secretion is necessary for the emulsifying of fat. When fats are not emulsified, they do not pass through the walls of the intestine; or, in other words, they are not absorbed and not utilized as food. The carbohydrates also fail of digestion, and the stools show a waste of these foods. When there is a failure in intestinal digestion, there is, accompanying this failure, colitis, because, if these foods are not digested, they go through an acetous and putrefactive change, which develops toxins, which are absorbed, and create irritation and inflammation of the mucous membrane of the intestine. Hence the importance of the pancreatic secretion may be seen in warding off the primary cause, not only of inflammation of the intestinal mucous membrane, but also of the diseases created by the absorbed toxins, as well as those that come from imperfect digestion of sugar, such as diabetes.

 

I. HEMORRHAGE

   Hemorrhage into the pancreas has been reported by the leading authorities. F. W. Draper, of Boston, reported that in four thousand autopsies he met with nineteen cases, in half of which no other disease was found. At this point I wish to state that that is one of the failures of postmortems and autopsies. They show organic disease, for they cannot show a functional disease, even if it is pronounced. Such examinations give no clue whatever to causation, They give no hint of perverted nutrition, and many of the lighter forms of organic derangement that may be the real cause of death; hence the fact that one-half of the subjects met with in the autopsies reported by Professor Draper presented no other cause for death than hemorrhage into the pancreas does not prove that there were no other causes; and post-mortems fail to reveal any cause of the hemorrhage into the pancreas. Those who inquire into the cause of death by autopsic examinations really find nothing except the effects of long-existing derangements in nutrition, caused by toxin poisoning. This being true, it is safe to give, as the principal etiological factor in the development of diseases of the pancreatic gland, any cause that deranges digestion and nutrition.

   Treatment.--The treatment should be preventive; for, after the disease is once established, there is no cure. Palliation is all that can be given. Just what the palliation should be depends upon the necessities of the case.

 

II. ACUTE PANCREATITIS

   This disease may be started by septic infection. it may be caused by an injury--a blow on the abdomen. As toxins are the principal cause, inebriety, and the use of other stimulants, such as coffee, tea, tobacco, etc., must be considered as so many causes.

   Symptoms.--This disease is said to begin very suddenly, with violent pains, on the order of colic, in the upper part of the abdomen. Nausea and vomiting follow. One of the pronounced cases that I have ever met with came into my hands after it had been developing for two weeks. The patient was a man forty-seven years of age. He was vomiting continually. The principal material ejected from the stomach was bile. Food could not be retained on the stomach at all. There was nothing that gave relief. At last I recommended an operation, which was performed, revealing the true cause of the trouble--namely, acute inflammation of the pancreas, with hemorrhagic spots throughout the entire organ. There was nothing to be done, and the patient died within a few hours after the surgical exploration.

   Acute pancreatitis may end in suppuration--an abscess. The symptoms will be on the order of dyspepsia. Severe pains, with vomiting, will be the principal symptom. Then palpation, or bimanual examination, must do the rest. It requires surgical skill in differential diagnosis, as a tumor, swelling, or mass will be felt in the region of the pancreas.

   Treatment.--The treatment for inflammation of this organ must be directed to correcting the digestion and assimilation. So long as there is pain and discomfort, the patient should be fasted. After that the eating should be fruit juice, and nothing else until all the symptoms have subsided; then a very light diet for a week or two. The diet should be fruit, raw vegetables, and cooked, nonstarchy vegetables, avoiding fats, starches, and sugars. In abscess of the pancreas there is no relief except by surgical operation.

   Tumors of the pancreas belong to surgical practice, the same as calculi of this organ. The treatment is strictly surgical. I will say, however, that those who are living a normal life will not develop such diseases,

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