Clinical examination of the pancreas in general is confined to the history, the serum glucose, amylase and lipase and the urinary glucose. The gland cannot be palpated except when very large or when fixed to the aorta and pushed forward by the pulse. Celsus in the first century AD described a condition likely to have been diabetes, Noting “excessive pouring out of urine” and causing “emaciation and danger.” Galen emphasized thirst, while sweet urine was described by the Hindus in the Brahman period in 500AD and later by the Englishman, Thomas Willis in the late 1600’s. Another Englishman, Matthew Dobson noted the sweetness of both the urine and the blood about 100 years after Willis. It is very likely based on description that these physicians went so far in the clinical exam as to taste the urine of their patients! Talk about dedication to diagnosis, patient and research! The clinical clues of polydydypsia, polyphagia and polyuria remain the hallmarks of the clinical diagnosis of diabetes. The presence of jaundice and an enlarged gallbladder is reminiscent of the Courvoisier law, which states that that ‘if in the presence of jaundice the gallbladder is palpable, then the jaundice is unlikely to be due to a stone.’ The likely cause of this entity is therefore cancer in the head of the pancreas. Clay colored stools and dark urine would go along with the diagnosis of obstructive jaundice. These tools are clues but occur relatively late in the disease.