"No less revolutionary was the demonstration that the liver had
other things to do in the animal economy besides secreting bile.
This, at one blow, destroyed the then dominant conception that
the animal body was to be regarded as a bundle of organs, each
with its appropriate function, a conception which did much to
narrow inquiry, since when a suitable function had once been
assigned to an organ there seemed no need for further
investigations....
"No less pregnant of future discoveries was the idea suggested
by this newly-found-out action of the hepatic tissue, the idea
happily formulated by Bernard as 'internal secretion.' No part
of physiology is at the present day being more fruitfully
studied than that which deals with the changes which the blood
undergoes as it sweeps through the several tissues, changes by
the careful adaptation of which what we call the health of the
body is secured, changes the failure or discordance of which
entails disease. The study of these internal secretions
constitutes a path of inquiry which has already been trod with
conspicuous success, and which promises to lead to untold
discoveries of the greatest moment; the gate to this path was
opened by Bernard's work." (Sir M. Foster, _loc. cit._)
But the work to be done, before all the clinical facts of the disease
can be stated in terms of physiology, is not yet finished. In England,
especial honour is due to Dr. Pavy for his life-long study of this
most complex problem.
V
THE PANCREAS
Here again Claude Bernard's name must be put first. Before him, the
diverse actions of the pancreatic juice had hardly been studied.
Vesalius, greatest of all anatomists, makes no mention of the duct of
the pancreas, and speaks of the gland itself as though its purpose
were just to support the parts in its neighbourhood--_ut ventriculo
instar substerniculi ac pulvinaris subjiciatur_. The duct was
discovered by Wirsung, in 1642: but anatomy could not see the things
that belong to physiology. Lindanus (1653) said, _I cannot doubt that
the pancreas expurgates, in the ordinary course of Nature, those
impurities of the blood that are too crass and inept to be tamed by
the spleen: and, in the extraordinary course, all black bile, begotten
of disease or intemperate living_. Wharton (1656) said, _It ministers
to the nerves, taking up certain of their superfluities, and remitting
them through its duct into the intestines_. And Tommaso Bartholini
(1666) called it the _biliary vesicle of the spleen_.
This chaos of ideas was brought into some sort of order by Regnier de
Graaf, pupil of François de Bois (Sylvius). De Bois had guessed that
the pancreas must be considered not according to its position in the
body, but according to its structure: that it was analogous to the
salivary glands. He urged his pupil to make experiments on it: and de
Graaf says:--
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