Affections of the Pancreas and Diabetes

     The reported wounding of the pancreas in the President’s case suggests at least one physiological question which might have had a direct bearing upon his death. This question relates to the subject of accidental diabetes, and the possible effect of this condition, if it was present, on the gangrenous state of the wounds. Minkowski is authority for the statement that the complete extirpation of the pancreas in dogs invariably leads to diabetes. According to Minkowski the time which elapses after the extirpation of the pancreas and the appearance of sugar in the urine varies. Frequently after but a few hours the glycosuria is noted, and sometimes only after the elapse of three days. Hemorrhage into the pancreas in man has upon several occasions given rise to diabetes, such cases having been reported by Sarfert (Deutsche Zeitschr f. Chir., 1895, Bd. 42, S. 125) and Cutler (Boston Med. and Surg. Jour., II, 4, 1895). It is well known, as we point out elsewhere, that gangrene is not uncommonly seen in wounds and in suppurative lesions—such as boils and carbuncles—in cases of diabetes.