In a previous paper,1 the fatal effect of continued loss of the entire external secretion of the pancreas after intubation of the main pancreatic duct was described. Death occurred in from five to eight days. At that time the cause of death remained unexplained. A few studies of the blood showed dehydration and reduction in the chloride concentration, and, unexpectedly, an increased alkalinity in the serum, an observation difficult to explain on the basis of extensive loss of such an alkaline secretion as the pancreatic juice. Further examination of the evidence, however, revealed the fact that these observations on the blood were made in dogs that had vomited considerably, a symptom of the gastric irritability almost always present to more or less severe degree in animals thus deprived of pancreatic juice. Vomiting, it was soon noted, was apt to be severe in animals that drank copiously, or in those
ELMAN R, HARTMANN AF. THE CAUSE OF DEATH FOLLOWING RAPIDLY THE TOTAL LOSS OF PANCREATIC JUICE. Arch Surg. 1930;20(2):333–337. doi:10.1001/archsurg.1930.01150080161009
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