From Alzheimer’s to Zebrafish: Eclectic Science and Regulatory Stories 102
Many years ago, one of America’s most accomplished medical writers, Dr. Lewis Thomas,
described how insecure he would be if faced with taking on the responsibilities of his
liver. He wrote that he was considerably less intelligent and unable to make all of the deci-
sions for which the liver is designed.1 Thomas would have been even more humble had
he chosen the pancreas. When it functions properly, this organ is silent and unrecognized,
but when it malfunctions, extraordinary complications and even death can ensue. Even
now, in the 21st century, when medical discoveries abound, the pancreas carries an aura
of mystery, and its diseases present a challenge for diagnosis and treatment.2 Fortunately,
research is ongoing, and progress is being made to treat pancreatic diseases. This article
describes the discovery, anatomy and function of the pancreas and discusses pancreatic
cancer and its treatment.
History
Apparently, the pancreas was first described by the Greek anatomist and surgeon
Herophilus, in approximately 310 BC. Herophilus (335–280 BC) may have been one of the
first surgeons to dissect the human body using criminals from prison. He was given royal
permission to procure them, even though there was public criticism of the practice. The
reason may have been that some of his dissections were performed while the criminals
were still alive. Herophilus, however, did not name the pancreas. The term may first have
been used by Aristotle (384–322 BC) in his treatise Histora Animalium, although there was
some controversy regarding his description.3
Four hundred years after Herophilus, in about 100 AD, Ruphos of Ephesus made
reference to the pancreas. His work On the names of parts of the human body was a compre-
hensive treatise on anatomical nomenclature. Writing in Greek, Ruphos named the organ
“pancreas” and differentiated it clearly from mesenteric lymph nodes.4
Galen (129–216 AD), a physician who lived during the century after Ruphos, com-
pared pancreatic juice to saliva, and had a vague idea of the digestive process. Galen also
identified the pancreas as a gland and described the blood vessels lying behind and pos-
sibly supplying it. His concept of the pancreas as a protective cushion for the mesenteric
vessels was accepted by all authors as indisputable until the 17th century, thus blocking
research on pancreatic physiology for centuries. For all his mistakes, Galen remained an
unchallenged authority and established a legacy that continued at least until the Middle
Ages.5 During those years, little progress was made in medicine as human anatomic dis-
section was forbidden by the Catholic Church. Diseases were considered a punishment
inflicted by God.6
It was not until the latter half of the 15th century that the first signs of advancements
in medicine became apparent. Giacomo Berengario da Carpi (1470–1550), a professor of
surgery in Bologna, Italy, produced the first illustrated textbook of anatomy. He accurately
described the bile duct and wrote of the pancreas as a secretory gland. His work was
followed by one of true genius several years later. In 1543, Andreas Vesalius (1515–64)
published his famous textbook of anatomy, De Humani corporis fabrica libri VII (“Seven
books on the workings of the human body”). His book was beautifully illustrated and
epitomized the confluence of science, technology and culture in a way that few other
books have ever done.7 With its publication, medicine was finally lifted out of medieval
murkiness and misinformation. The book, an outgrowth of the vigorous spirit of the
Renaissance, corrected a number of Galen’s errors and returned society to the logical
thought and observational methods of the ancient Greeks.
Vesalius pictured the pancreas as a U-shaped gland attached to mesentery (the fold of
peritoneum attaching the intestine to the posterior abdominal wall). Vesalius’ work was
followed by the discovery of the pancreatic duct by Johann Georg Wisüng (1589–1643),
which proved to be one of the great milestones in the history of knowledge of the pan-
creas.8 His work not only described a small duct, which added to previous knowledge of
Many years ago, one of America’s most accomplished medical writers, Dr. Lewis Thomas,
described how insecure he would be if faced with taking on the responsibilities of his
liver. He wrote that he was considerably less intelligent and unable to make all of the deci-
sions for which the liver is designed.1 Thomas would have been even more humble had
he chosen the pancreas. When it functions properly, this organ is silent and unrecognized,
but when it malfunctions, extraordinary complications and even death can ensue. Even
now, in the 21st century, when medical discoveries abound, the pancreas carries an aura
of mystery, and its diseases present a challenge for diagnosis and treatment.2 Fortunately,
research is ongoing, and progress is being made to treat pancreatic diseases. This article
describes the discovery, anatomy and function of the pancreas and discusses pancreatic
cancer and its treatment.
History
Apparently, the pancreas was first described by the Greek anatomist and surgeon
Herophilus, in approximately 310 BC. Herophilus (335–280 BC) may have been one of the
first surgeons to dissect the human body using criminals from prison. He was given royal
permission to procure them, even though there was public criticism of the practice. The
reason may have been that some of his dissections were performed while the criminals
were still alive. Herophilus, however, did not name the pancreas. The term may first have
been used by Aristotle (384–322 BC) in his treatise Histora Animalium, although there was
some controversy regarding his description.3
Four hundred years after Herophilus, in about 100 AD, Ruphos of Ephesus made
reference to the pancreas. His work On the names of parts of the human body was a compre-
hensive treatise on anatomical nomenclature. Writing in Greek, Ruphos named the organ
“pancreas” and differentiated it clearly from mesenteric lymph nodes.4
Galen (129–216 AD), a physician who lived during the century after Ruphos, com-
pared pancreatic juice to saliva, and had a vague idea of the digestive process. Galen also
identified the pancreas as a gland and described the blood vessels lying behind and pos-
sibly supplying it. His concept of the pancreas as a protective cushion for the mesenteric
vessels was accepted by all authors as indisputable until the 17th century, thus blocking
research on pancreatic physiology for centuries. For all his mistakes, Galen remained an
unchallenged authority and established a legacy that continued at least until the Middle
Ages.5 During those years, little progress was made in medicine as human anatomic dis-
section was forbidden by the Catholic Church. Diseases were considered a punishment
inflicted by God.6
It was not until the latter half of the 15th century that the first signs of advancements
in medicine became apparent. Giacomo Berengario da Carpi (1470–1550), a professor of
surgery in Bologna, Italy, produced the first illustrated textbook of anatomy. He accurately
described the bile duct and wrote of the pancreas as a secretory gland. His work was
followed by one of true genius several years later. In 1543, Andreas Vesalius (1515–64)
published his famous textbook of anatomy, De Humani corporis fabrica libri VII (“Seven
books on the workings of the human body”). His book was beautifully illustrated and
epitomized the confluence of science, technology and culture in a way that few other
books have ever done.7 With its publication, medicine was finally lifted out of medieval
murkiness and misinformation. The book, an outgrowth of the vigorous spirit of the
Renaissance, corrected a number of Galen’s errors and returned society to the logical
thought and observational methods of the ancient Greeks.
Vesalius pictured the pancreas as a U-shaped gland attached to mesentery (the fold of
peritoneum attaching the intestine to the posterior abdominal wall). Vesalius’ work was
followed by the discovery of the pancreatic duct by Johann Georg Wisüng (1589–1643),
which proved to be one of the great milestones in the history of knowledge of the pan-
creas.8 His work not only described a small duct, which added to previous knowledge of