The relation of the duodenal mucosa to the internal secretion of the pancreas

Evidence that changes in the duodenal mucosa are present in diabetes mellitus is given by C. Workman in a private communication to Monroe (1906). A recent examination of Workman's autopsy protocols, in cases of diabetes, shows that hypertrophy of the duodenal mucosa and valvulæ conniventes was present in 10 out of 21 cases. The discovery of sercretion of the pancreas led Moore, Eadie and Abram (1906) to postulate that the duodenum also elaborated a hormone that excited the internal secretion of the pancreas. They administered acid aqueous extracts of the duodenal and upper intestinal muscosa to three cases of diabetes and found that in two cases the urine became sugar free. Bainbridge and Beddard (1906) were unable to confirm these findings and ascribed the favourable results obtained by Moore and his collaborators to dietary control. Following the discovery of insulin, several attempts were made to recover insulin from the duodenal mucosa. Ivy and Fisher (1924) isolated an insulin like substance from the gastric and duodenal mucosa and Dixon and Wadia (1926) observed that extracts of duodenal mucosa injected into dogs acted in a manner similar to insulin in that both produced an increase in the output of pituitrin.