The experiments indicate that the pancreas, when perfused aseptically with Locke's solution containing physiological concentrations of dextrose, does not alter the reducing properties of the perfused solution. The pancreas, however, seems to supply something to the Locke's solution circulating through its arteries which in some way brings about a utilization of sugar by the living heart to an extent that does not occur with the heart alone. This pancreatic substance possesses some of the characteristics of an enzyme. It is inactivated by boiling; it is unstable, rapidly becoming inactive on standing; it acts in small amounts; it causes a great acceleration in the rate of a reaction which otherwise proceeds slowly, and the rate of reaction diminishes as the reaction proceeds. Thus this substance has more of the characteristics of an enzyme than of a stable internal secretion like that of the adrenal glands. The disappearance of sugar was dependent upon the presence of living heart tissue, and it ceased as soon as the perfusate was removed from the heart-pancreas circulation and did not occur at all when a pancreatic perfusate was passed through a non-beating heart. This result indicates that the reaction is not similar to that obtained when muscle and pancreas extracts act on more concentrated solutions of dextrose.

The living heart in the presence of the pancreatic factor and dextrose, is responsible for two effects. First, a condensation of the sugar to a non-reducing form that yields again a simple sugar on hydrolysis or by simply standing, with a preservative, at 37°C. for 24 hours. Second, a disappearance of sugar which is probably due to its destruction by hydrolysis or oxidation. After deducting the reducing sugar in the heart-pancreas perfusions which could be recovered by hydrolysis, the amount of sugar which had actually disappeared exceeded that which was used by the heart when perfused with dextrose alone. As to the fate of this portion of the sugar, no definite evidence was obtained.

The question arises as to whether this substance obtained from the perfused pancreas is identical with the hypothetical internal secretion of the pancreas so essential in sugar metabolism. That there is an internal secretion of the pancreas which can be obtained by this method, and that in some way it accelerates the utilization of sugar by the living heart, seems evident. Though the conclusions are based on the heart and pancreas isolated from the numerous interrelating factors occurring in the body, the evidence suggests, at least, that the substance or substances obtained by perfusing the pancreas may be concerned in the normal activity of the pancreas upon sugar metabolism.

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