The theoretic considerations which indicate that fibrocystic disease of the pancreas is the result of a congenital deficiency of secretin have been outlined. The varied clinical and pathologic manifestations of this disease can, in our opinion, be more nearly adequately explained by this hypothesis than by any of the other current theories. The absence of secretin (S1) in the upper part of the intestinal tract of a patient with fibrocystic disease of the pancreas lends support to this theory; which is to say, that the condition is the result of a congenital deficiency of secretin. It has been shown to be possible to extract secretin from the upper part of the intestinal tract of persons two months to 73 years old. The only consistent, failures occurred in work with patients in the neonatal period. Successful extraction of secretin from these patients in the neonatal period can be carried out, however, by combining the crude extracts obtained from a number of patients. The extraction of secretin is successful if it is done up to 15 hours postmortem. If the specimen is kept in a frozen state, extraction can be delayed without loss of activity as long as 39 days. Because this method of extraction is successful in individual cases at necropsy, it becomes possible to correlate the presence or absence of secretin with varying pathologic conditions. This, in turn, may open up a broad field for the investigation of many pancreatic and intestinal disturbances in addition to fibrocystic disease of the pancreas.
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