We shall first examine the abnormities affecting the parenchyma of the above-named glands, and then proceed to examine those of their efferent ducts, and of their contents. We may observe, generally, that these organs are not very liable to become diseased.

1. Abnormities Of The Pancreas And The Salivary Glands

1. Defect And Excess Of Formation

Absence of the pancreas and the salivary glands is only observed in very imperfect monstrosities; salivary glands sometimes present an arrest at a very low stage of development, inasmuch as they may be blended with one another and with the thymus and thyroid glands, so as to form one mass. Excess of development occurs very rarely in the shape of a double pancreas, or of an extravagant development of accessory appendages.

2. Deviation In Size

Enlargement of the above-named glands, in consequence of hypertrophy, is altogether unusual; but when it does occur it affects not so much the acini themselves, as the interstitial cellular tissue. The gland therefore almost invariably becomes more compact and drier, and then presents simple non-malignant induration.

A diminution of the pancreas is the result of atrophy. Occasionally, and particularly at an advanced age, this takes place spontaneously, or it may be induced, secondarily, by other anomalies, such as chronic inflammation and adipose infiltration, or the deposition of calcareous matter in the efferent ducts. The atrophic state is accompanied by variations of consistency, the organ sometimes presenting coriaceous tenacity, at others a lax and pultaceous condition.

3. Deviations Of Consistency

We meet with the most various degrees of consistency in the pancreas. The two extremes only come within the range of pathology; they are on the one hand extreme cartilaginous dryness of the tissue, and induration which is generally coupled with enlargement; on the other extreme softening, relaxation, and succulence of the tissue.

4. Diseases Of The Tissues

A. Inflammation

Inflammation of the salivary glands is either acute or chronic, and it is either primary or secondary; in the latter case it is metastatic. Inflammation of the pancreas, at all events in the acute form, is extremely rare:• this is not the case with the other salivary glands, especially with the parotis; here the inflammation is very often primary, and still more frequently metastatic.

The acute form is characterized in the following manner: in the first instance there is tumefaction of the gland, reddening, congestion, relaxation, and succulence, i. e. infiltration of the interstitial cellular tissue; in the progress and in the higher stage of the disease, a sarcomatous condensation of the cellular tissue follows as a consequence of plastic exudation into its areolae; the congestion and reddening attack the acini, which appear to be fused with the former, and the entire gland is enlarged and indurated. Unless the inflammation pass into resolution, small punctiform abscesses result, which enlarge, become more numerous and coalesce; the gland, and particularly the cellular tissue, is now found uniformly infiltrated with yellow pus, which exudes from it as from a sponge, whilst the acini appear as small, red, lax, friable corpuscles, which fuse at a later period; or suppuration is established at distinct spots so as to form an abscess, which may discharge itself in various directions, subsequent to the destruction of the adjacent tissues.

Chronic inflammation induces condensation, induration of the cellular tissue, obliteration of the acini, and either permanent enlargement or subsequent atrophy of the gland.

The metastatic forms of inflammation not unfrequently pass rapidly from the stage of hyperaemia with livid redness, into sanious ulceration, with sudden disappearance of the turgor.

B. Adventitious Growths

The salivary glands are not very subject to the formation of morbid growths; tubercle is never discovered in them, and carcinoma rarely attacks them primarily. We find the pancreas liable to a. Excessive accumulation of fat, which may terminate in a conversion of the entire organ into one mass of fat. This affection rarely occurs without a coincident accumulation of fat in the abdomen. The disease proceeds from without inwards, and in very obese persons a direct communication may be traced between the surrounding fat and the pancreas; the cellular tissue gradually absorbing the lax greasy fat, the acini, which are of a dirty yellow color, being reduced and gradually disappearing. When the disease has attained its extreme limits, a mere pultaceous strip of fat retaining the general outlines of the gland is found in its place; only scattered remains of the acini are discoverable, and in the delicate and thinned duct there is a whey-like fatty fluid. The disease occurs frequently in drunkards, associated with fatty liver and the formation of biliary calculi.

B. Cysts

Serous cysts are occasionally formed in the pancreas, as well as in other salivary glands. They are to be carefully distinguished from dilatations of the ducts and their terminations, which put on a similar appearance.

r. Fibrous tissue, cartilaginous and osseous growths. Tumors of this description occur but very rarely in the parotid.

D. Carcinoma

Carcinomatous disease occurs, in the pancreas and salivary glands, and especially in the parotid, in the shape of scirrhus and medullary cancer. In the parotid it sometimes appears as a primary disease; in the pancreas we have only found it, and even then exclusively at its duodenal end, as a complication of extensive carcinoma of numerous other organs. The secondary affection of the salivary glands by an extension of the disease from adjoining organs, and in the case of the pancreas especially, by an extension from the scirrhous pylorus, is very common. Cancer appears in the shape of infiltration of the interstitial cellular tissue of the gland or of nodes. Dr. Berg has, during his residence in Vienna, discovered carcinomatous induration of the entire pancreas in a new-born child.