See also:

• PANCREAS (Gr. rag, all; 1cpks, flesh)

PANCREAS (Gr. rag, all; 1cpks, flesh)  , or See also:

• SWEETBREAD

sweetbread, in See also:

• ANATOMY
• ANATOMY (Gr. avaroyil, from ava-silo c', to cut up)

anatomy, the elongated, See also:

• TONGUE (O. Eng. lunge)

tongue-shaped, See also:

• DIGESTIVE

digestive gland, of a pinkish See also:

• COLOUR (Lat. color, connected with celare, to hide, the root meaning, therefore, being that of a covering)

colour, which lies across the posterior See also:

• WALL (O. Eng. weal, weall, Mid. Eng. wal, wane, adapted from Lat. vallum, rampart; the original O. Eng. word for a wall was wag or tenth)
• WALL, RICHARD (1694-1778)

wall of the See also:

• ABDOMEN (a Latin word, either from abdere, to hide, or from a form adipomen, from adeps, fat)

abdomen about the level of the first lumbar vertebra behind, and of the transpyloric See also:

• PLANE

plane in front (see ANATOMY: Superficial and See also:

• ARTISTIC

Artistic) . Its right end is only a little to the right of the See also:

• MID

mid lineof the abdomen and is curved down, See also:

• ROUND (O. Fr. rond, Lat. rotundus, the Fr. is the source also of Du. rond; Ger., Swed., Dan. and Nor. rond)

round the See also:

• SUPERIOR

superior med.-enteric vessels, into the See also:

• FORM (Lat. forma)

form of a C . This See also:

• HOOK, JAMES CLARKE (1819-1907)
• HOOK, THEODORE EDWARD (1788-1841)
• HOOK, WALTER FARQUHAR (1798-1875)

hook-like right end is known as the See also:

• HEAD (in 0. Eng. heafad; the word is common to Teutonic languages; cf. Dutch hoofd, Ger. Haupt, generally taken to be in origin connected with Lat. caput, Gr. KerbOvi7)
• HEAD, SIR EDMUND WALKER, BART
• HEAD, SIR FRANCIS BOND, BART

head of the See also:

• PANCREAS (Gr. rag, all; 1cpks, flesh)

pancreas, and its curvature is adapted to the concavity of the duodenum (see fig.) The first See also:

• INCH (O. Eng. ynce from Lat. uncia, a twelfthpart; cf. " ounce," and see As)

inch of the straight See also:

• LIMB

limb is narrower from above downward than the See also:

• REST (O. Eng. rest, reste, bed, cognate with other Teutonic forms, e.g. Ger. Rast, Riiste, rest, and probably Gothic Rasta, league, i.e. resting or stopping place)

rest and forms the See also:

• NECK (O. Eng. hnecca; the word appears in many Teutonic languages; cf. Dutch ride, Ger. Nacken; in O. E. the common word was heals; cf. Ger. Hals)

neck . This See also:

• PART

part lies just in front of the beginning of the portal vein, just below the pyloric opening of . the See also:

• STOMACH (Gr. vrbsaxos from arbga, a mouth)

stomach and just above the superior mesenteric vessels . The next three or four inches of the pancreas, to the See also:

• LEFT

left of the neck, form the See also:

• BODY

body and this part lies in front of the left See also:

• KIDNEY

kidney and See also:

• ADRENAL

adrenal body, while it See also:

• HELPS, SIR ARTHUR (1813-1875)

helps to form the posterior wall of the " stomach chamber " (see ALIMENTARY See also:

• CANAL
• CANAL (from Lat. canalis, " channel " and " kennel " being doublets of the word)

CANAL) . At its left extremity the body tapers to form the tail, which usually touches the See also:

• SPLEEN (Gr. o-1rXilv)

spleen (see DUCTLESS GLANDS) just below the hilum, and above the basal triangle of that viscus where the splenic flexure of the See also:

• COLON
• COLON (formerly known as ASPINWALL)

colon is situated . On the upper border of the body, a little to the left of the mid See also:

• LINE

line of the abdomen, is a convexity or hump, which is known as the tuber omentale of the pancreas, and touches the See also:

• ELEVATION

elevation (bearing the same name) on the See also:

• LIVER (O. Eng. lifer; cf. cognate forms, Dutch lever, Ger. Leber, Swed. lefver, &c.; the O. H. Ger. forms are libara, lipora, &c.; the Teut. word has been connected with Gr. i'prap and Lat. jecur)

liver . The pancreas is altogether behind the peritoneum . In its greater part it is covered in front by the lesser See also:

• SAC

sac (see COELOM AND SEROUS MEMBRANES), but the See also:

• LOWER

lower part of the front of the head and the very narrow lower See also:

• SURFACE

surface of the body are in contact with the greater sac . There is one See also:

• MAIN (from the Aryan root which appears in " may " and " might," and Lat. magnus, great)
• MAIN (Lat. Moenus)

main duct of the pancreas, which is sometimes known as the duct of Wirsung; it is thin-walled and See also:

• WHITE
• WHITE, ANDREW DICKSON (1832– )
• WHITE, GILBERT (1720–1793)
• WHITE, HENRY KIRKE (1785-1806)
• WHITE, HUGH LAWSON (1773-1840)
• WHITE, JOSEPH BLANCO (1775-1841)
• WHITE, RICHARD GRANT (1822-1885)
• WHITE, ROBERT (1645-1704)
• WHITE, SIR GEORGE STUART (1835– )
• WHITE, SIR THOMAS (1492-1567)
• WHITE, SIR WILLIAM ARTHUR (1824--1891)
• WHITE, SIR WILLIAM HENRY (1845– )
• WHITE, THOMAS (1628-1698)
• WHITE, THOMAS (c. 1550-1624)

white, and runs the whole length of the See also:

• ORGAN

organ nearer the back than the front . As it reaches the head it turns downward and opens into the second part of the duodenum, joining the See also:

• COMMON

common bile duct while they are both piercing the walls of the gut . A smaller See also:

• ACCESSORY

accessory pancreatic duct is found, which communicates with the main duct and usually opens into the duodenum about three-quarters of an inch above the papilla of the latter .

It drains the lower part of the head, and either crosses or communicates with the duct of Wirsung to reach its opening (see A . M . See also:

• SCHIRMER, FRIEDRICH WILHELM (1802—1866)
• SCHIRMER, JOHANN WILHELM (1807-1865)

Schirmer, Beitrag zur Geschichte and Anat. See also:

• DES

des Pancreas, See also:

• BASEL (Fr. Bale)
• BASEL (Fr. Belle, but Basle is a wholly erroneous form; Ital. Basilea)
• BASEL, CONFESSION OF
• BASEL, COUNCIL OF

Basel, 1893) . The pancreas has no real See also:

• CAPSULE (from the Lat. capsula, a small box)

capsule, but is divided up into lobules, which are merely held together by their ducts and by loose areolar See also:

• TISSUE (Fr. tissu, tissue, participle of tisser, Lat. texere, to weave)

tissue; the glands of which these lobules are made up are of the acino-tubular variety (see See also:

• EPITHELIAL, ENDOTHELIAL

EPITHELIAL TissuEs) . Small See also:

• GROUPS
• GROUPS, THEORY

groups of epithelium-like cells without ducts (Islets of Langerhans) occur among the glandular tissue and are characteristic of the pancreas . In cases of See also:

• DIABETES (from Gr. &a, through, and faivecv, to pass)

diabetes they sometimes degenerate . In the centre of each See also:

• ACINUS (Lat. for a berry)

acinus of the main glandular tissue of the pancreas are often found spindle-shaped cells (centro-acinar cells of Langerhans) . For details of microscopic structure see Essentials of See also:

• HISTOLOGY
• HISTOLOGY (Gr. Ler6c, web, tissue, properly the web-beam of the loom, from iQravai, to make to stand)

Histology, by E . A . Schafer (See also:

• LONDON

London, 1907) . See also:

• EMBRYOLOGY

Embryology.—The pancreas is See also:

• DEVELOPED

developed, by three diverticula, from that part of the foregut which will later form the duodenum . Of these diverticula the left ventral disappears See also:

• EARLY
• EARLY, JUBAL ANDERSON (1816-1894)

early,' but the right ventral, which is really an outgrowth from the lower part of the common bile duct, forms the head of the pancreas .

The body and tail are formed from the dorsal diverticulum, and the two parts, at first See also:

• SEPARATE

separate, join one another so that the ducts communicate, and eventually the ventral one takes almost all the secretion of the gland to the See also:

• INTESTINE (Lat. intestinus, internal, usually in neuter plural intestina. from intus, within)

intestine, while that part of the dorsal one which is nearest the duodenum atrophies and forms the duct of Santorini . The main pancreatic duct (of Wirsung) is therefore formed partly by the ventral and partly by the dorsal diverticulum . As the diverticula grow they give off lateral branches, which See also:

• BRANCH (from the Fr. branche, late Lat. branca, an animal's paw)

branch again and again until the terminal buds form the acini of the gland . At first the pancreas grows upward, behind the stomach, between the two layers of the dorsal mesogastrium (see COELOM AND SEROUS MEMBRANES), but when the stomach and duodenum turn over to the right, the gland becomes See also:

• HORIZONTAL

horizontal and the opening of the right ventral diverticulum becomes more dorsal . Later, by the unequal growth of the duodenal walls, it comes to enter the gut on its left See also:

• SIDE
• SIDE (mod. Eski Adalia)

side where the papilla is permanently situated . After the turning over of the pancreas to the right the peritoneum is absorbed from its dorsal aspect . The islets of Langerhans are now regarded as portions of the glandular epithelium which have been isolated by the invasion and growth round them of mesenchyme (see See also:

• QUAIN, SIR RICHARD, BART

Quain's Anatomy, vol. i., 1908) . See also:

• COMPARATIVE

Comparative" Anatomy.—In the See also:

• ACRANIA

Acrania (See also:

• AMPHIOXUS, or LANCELET

Amphioxus) no representative of a pancreas has been found, but in the See also:

• CYCLOSTOMATA, or MARSIPOBRANCHII

Cyclostomata (hags and lampreys) there is a small lobular gland opening into the bile duct which probably represents it . In the Elasmobr2'nchs (sharks and rays) there is a definite compact pancreas of consider-able See also:

• SIZE

size . In the Teleostomi, which include the . true bony See also:

• FISH (O. Eng. fist, a word common to Teutonic languages, cf. Dutch visch, Ger. Fisch, Goth. fisks, cognate with the Lat. piscis)
• FISH, HAMILTON (1808-1893)

fish (Teleostei), the See also:

• STURGEON (Acipenser)

sturgeon and Polyterus, the pancreas is sometimes 1 N . W . Ingalls has shown (Archiv. f. mik .

Anat. and Entwickl . Bd . 70, 1907), that in a human embryo of 4.9 mm. the two ventral buds persist and join one another below the liver bud . XX . 22 a compact gland and sometimes diffuse between the layers of the mesentery; at other times it is so surrounded by the liver as to be difficult to find . Among the Dipnoi (mud fish), Protopterus has it embedded in the walls of the stomach and intestine . The See also:

• AMPHIBIA

Amphibia have a definite compact pancreas which lies in the U-shaped See also:

• LOOP

loop between the stomach and duodenum, and is massed round the bile duct . In the Reptilia there are some-times several ducts, as in the See also:

• CROCODILE

crocodile and the See also:

• WATER

water See also:

• TORTOISE

tortoise (Emys), and this arrangement is also found in birds (the See also:

• PIGEON

pigeon, for instance. has three ducts opening into the duodenum at very different levels) . In mammals the gland is usually compact, thoughinto the pancreas is of some medico-legal importance as being a cause of See also:

• DEATH

death . The See also:

• CONDITION (Lat. condicio, from condicere, to agree upon, arrange; not connected with conditio, from condere, conditum, to put together)

condition is rarely recognized in See also:

• TIME (0. Eng. Lima, cf. Icel. timi, Swed. timme, hour, Dan. time; from the root also seen in " tide," properly the time of between the flow and ebb of the sea, cf. O. Eng. getidan, to happen, " even-tide," &c.; it is not directly related to Lat. tempus)
• TIME, MEASUREMENT OF
• TIME, STANDARD

time for operative interference . Acute haemorrhagic pancreatitis is a c mbination of inflammation with See also:

• HAEMORRHAGE (Gr. atµa, blood, and prryvvvac, to burst)

haemorrhage in which the patu.reas is found enlarged and infiltrated with See also:

• BLOOD

blood . Violent See also:

• PAIN (from Lat. poena, Gr. robin, penalty, that which must be paid: O. Fr. peine)
• PAIN, BARRY (1867– )

pain, vomiting and collapse, are the See also:

• CHIEF (from Fr. chef, head, Lat. caput)

chief features as is also the See also:

• CASE
• CASE, JOHN (d. 1600)

case in pancreatic See also:

• ABSCESS (from Lat. abscedere, to separate)

abscess in which the abscess may be single or multiple .

In the latter case operation has been followed by recovery . Haemorrhagic inflammation has been followed by See also:

• GANGRENE (from Gr. y&yypawa, an eating sore, from ypaivewv, to gnaw)

gangrene of the pancreas, which usually terminates fatally . In two remarkable cases; however, reported by Chiari recovery followed on the See also:

• DISCHARGE (adapted from the O. Fr. discharge, modern decharge, from a med. Lat. discargare, to unload, dis- and earn care, to load, cf. " charge ")

discharge per rectum of the necrosed pancreas . Chronic pancreatitis is said by Aorta See also:

• FOSSE (or Foss) WAY

Fosse for Spigelian See also:

• LOBE

lobe Right phrenic vessels Vena cava Hepatic vein hepatic artery tEsophaguss: . Coronary artery See also:

• DIAPHRAGM (Gr. Scat/pay,aa, a partition)

Diaphragm Left suprarenalcapsnjfd Portal vein Fylorus Rile duct Right suprarenal capsule See also:

• TINDER (O. Eng. tyndre, from tindan, tendan, to kindle, cf. Dan. tonder, Ger. anzunden)

tinder surface of pancreas Attachmenj. of transverse' gtesocolon Ureter/ yferior mesen- teric artery pertnatic vein /- Ureter Right common iliac vein Right common iliac artery Left million iliac , ' vein Duodeno-, N iejunal fletiUt'b Gastro•duodenal artery and neck of pancreas Superior mesefi See also:

• TERM

term artery Duodenum From See also:

• AMBROSE (AMBROISE), AUTPERT (d.' 778)
• AMBROSE (ANDREY SERTIS-KAMENSKIY) (1708-1771)
• AMBROSE (fl. 119o)
• AMBROSE, ISAAC (1604-1663/4)
• AMBROSE, SAINT (c. 340-307)

Ambrose See also:

• BIRMINGHAM

Birmingham, See also:

• CUNNINGHAM, ALEXANDER (c.1655-173o)
• CUNNINGHAM, ALLAN (1784-1842)
• CUNNINGHAM, WILLIAM (1805-1861)

Cunningham's See also:

• TEXT (Lat. textum, woven fabric, from texere, to weave)

Text See also:

• BOOK

Book of Anatomy . The stomach, liver and most of the intestines have been removed . The peritoneum has been preserved on the right kidney, and the fossa for the Spigelian lobe . In taking out the liver, the vena cava was left behind . The stomach-See also:

• BED
• BED (a common Teutonic word, cf. German Bett, probably connected with the Indo-European root bhodh, seen in the Lat. fodere, to dig; so " a dug-out place " for safe resting, or in the same sense as a garden " bed ")

bed is well shown . (From a body hardened by chromic-See also:

• ACID (from the Lat. root ac-, sharp; acere, to be sour)

acid injections.) t.0 sometimes, as in the See also:

• RABBIT

rabbit, it is diffuse . It usually 'has two ducts, as in See also:

• MAN
• MAN, ISLE OF (anc. Mona)

man, though in many animals, such as the ox, See also:

• SHEEP
• SHEEP (from the Anglo-Saxon sceap, a word common in various forms to Teutonic languages; e.g. the German Schaf)

sheep and See also:

• GOAT (a common Teut. word; O. Eng. gat, Goth. gaits, Mod. Ger. Geiss, cognate with Lat. haedus, a kid)

goat, only "one persists . When there is only one duct it may open with the common bile duct, e.g. sheep and See also:

• CAT
• CAT, CIVET
• CAT, HOUSE

cat, or may be very far away as in the ox and rabbit .

(F . G . P.) Diseases of the pancreas.—As the pancreas plays an important part in the See also:

• PHYSIOLOGY (from Gr. 4 i s, nature, and koyos, discourse)

physiology of digestion much See also:

• ATTENTION (from Lat. ad-tendo, await, expect; the condition of being " stretched " or " tense ")

attention has of See also:

• LATE

late been paid to the question of its secretions . In sclerosis, See also:

• ATROPHY (Gr. It- priv., rpo4, nourishment)

atrophy, acute and chronic inflammatory changes and new growths in the pancreas an See also:

• ABSENCE (Lat. absentia)

absence or lessening of its secretion may be evident . Haemorrhage See also:

• MAYO
• MAYO, RICHARD SOUTHWELL BOURKE, 6TH EARL OF (1822-1872)

Mayo See also:

• ROBSON, STUART (1836-1903)

Robson to occur in connexion with the symptoms of catarrhal See also:

• JAUNDICE (Fr. jaunisse, from jaune, yellow), or IUTERUS (from its resemblance to the colour of the golden oriole, of which Pliny relates that if a jaundiced person looks upon it he recovers but the bird dies)

jaundice, which he suggests is due to the pressure on the common duct by the swollen pancreatic tissue . The organ is enlarged and very hard, and the symptoms are pain, See also:

• DYSPEPSIA (from the Gr. prefix Sur-, hard, ill, and 'irirreiv, to digest)

dyspepsia, jaundice, loss of See also:

• WEIGHT

weight and the presence of See also:

• FAT (O.E. fdett; the word is common to Teutonic languages, cf. Dutch vet, Ger. Fett, &c., and may be ultimately related to Greek Irian, and =apos, and Sanskrit pivan)

fat in the stools . This latter sign is common to all forms of pancreatic disease . In connexion with all pancreatic diseases small yellowish patches are found in the ,pancreatic tissue, mesentery, omentum and abdominal fatty tissue generally, and the tissues appear to be studded with whitish areas often not larger than a See also:

• PIN (a doublet with " pen " from Lat. pinna, feather, pinnacle, which is said to contain the same root as irirvs, pine tree, and properly to mean a sharp point or end)

pin's head . The condition, which was 20 first observed by Balser, has been termed " fat-See also:

• NECROSIS (Gr. vEKpos, corpse)

necrosis." The pancreas like other See also:

• ORGANS

organs, is subject to the occurrence of new growths, tumours and cysts, syphilis and See also:

• TUBERCULOSIS

tuberculosis .