Pancreatin.

Occurrence—Pancreatin is found in the fresh pancreas of warm-blooded animals, and is obtained for general use from the pancreas of the hog.

CONSTITUENTS—Pancreatin is a mixture of several enzymes, consisting of the ferment trypsin, similar to that of pepsin, proteolytic in character, but active in an alkaline medium; a starch digesting ferment—amylopsin resembling diastase or ptyalin; a milk digesting ferment, and a fat emulsifying ferment—stearopsin, closely allied to that found in the bile.

A solution of pancreatin is prepared, called Liquor Pancreaticus. The fresh pancreas is finely minced and exhausted with water, strained and treated with dilute alcohol for preservation. This is often more active than the powder.

Description—Pancreatin is a grayish or yellowish amorphous powder, with a characteristic odor and taste, soluble in water, insoluble in alcohol and chloroform.

Administration—It is most active in an alkaline medium, is destroyed in a strongly acid medium, and is consequently best given from two to three hours after eating, when it assists the intestinal digestion. Dose, from two to twenty grains.

Physiological Action—It will peptonize various articles of food, such as milk, oysters, broths and gruel, and will emulsify oils and fatty foods intended for rapid nutrition.

Specific Symptomatology—Pain in the intestinal canal, beginning an hour or more after eating, and continuing for two or three hours; eructations of fatty foods; passage of undigested fats with the feces, are all indications for the use of pancreatin.

Without these indications it may be given in the slow convalescence of wasting disease, where anorexia and malnutrition are present and not corrected by pepsin and stomach tonics.

Therapy—The agent is of some use in gastric inactivity, but in the stomach, there is but little influence it may exercise that is not fully exercised by pepsin.

However, if administered at the beginning of a meal, it will sometimes exercise a full beneficial influence before enough of the gastric acids are poured out to retard its action-an influence sometimes more satisfactory than that exercised by pepsin, but as the acidity of the stomach fluids is apt to retard or destroy its influence, it is best given an hour or more after meals if there is impairment of the intestinal digestion, where it acts to the best advantage. If the stomach digestion is nearly complete, a dose of magnesium or sodium carbonate or bicarbonate may be given to neutralize any excess of acid.

It will accomplish desirable results in lienteric diarrhea and in the diarrheas of infants where there is marked emaciation, the stools containing fat cells in abundance.

Pancreatin, the liquor pancreaticus, or the powdered pancreatic glands are advised in the treatment of diabetes mellitus. It is possible that some benefit has followed this method of treatment in cases where the pancreas was diseased, but the author has but little confidence in it in the larger proportion of cases.

The American Materia Medica, Therapeutics and Pharmacognosy, 1919, was written by Finley Ellingwood, M.D.
It was scanned by Michael Moore for the Southwest School of Botanical Medicine.