182 PHYSIOLOGY CHAI-. 



De Filippi iii anotlier dog, on which Monari (1893) had 

 performed almost total gastrotomy, repeated the results of 

 Carvallo aud Pachou. The latter (1894) also succeeded in keep- 

 ing a cat of 2 kilos, alive after total excision of the stomach. 

 After 25 days the animal weighed 420 grins, less. The milk 

 administered was not well digested, and clots of it, were seen in 

 the faeces. 



Among the cases of gastrotomy performed on man was one 

 recorded by Schuchardt, at Stettin. In 1895 he excised the 

 stomach of a patient to a somewhat smaller extent than in 

 Czerny's dog, and the man lived two and a half years in good 

 condition. At first he was only able to take small quantities 

 of food at each meal, but eventually he fed like a normal in- 

 dividual. At the post-mortem a small stomach (formed from a 

 portion of the cardia that had been left) was found which had 

 gradually acquired a capacity of 500 c.c. 



The case of the Zurich surgeon Schlatter was more remarkable. 

 In 1897 he excised the whole stomach from a woman of fifty-six 

 in whom it had formed into a hard tumour. Being unable to 

 suture the cardia to the duodenum, he turned the latter into a 

 blind sac, and bound the cardia with a loop of the small intestine. 

 The patient survived this amazing operation, and increased in 

 weight. During the first 8 weeks the food had to be given 

 in very small quantities, and always in a liquid or finely 

 minced form. 



A month after the operation, Wroblewski examined the 

 urine and faeces of this patient. For 13 days he found iudole 

 in the urine to an amount in excess of the normal, and for 3 days 

 in normal quantity ; the scatole was also rather in excess of 

 the normal. 



Four months after the operation, Hoffmann made further 

 investigations on the same case and estimated the nitrogen intro- 

 duced with the food and eliminated with the faeces and urine. 

 He found that the proteins were digested and absorbed in a 

 ratio approximating to the normal. The same was found of 

 the fats. 



Five months after the operation, as an index of the putrid 

 processes in the intestine, he determined the amount and ratio of 

 the inorganic sulphuric acid and the ethereal sulphuric acid in 

 the urine. He concluded that, after 5 months, putrefaction was 

 not in excess of the normal. Seven months after the operation 

 the patient had put on about 6 kilos, weight. 



In November 1898, Tricomi succeeded in operating on another 

 woman of forty -eight with complete success. This patient 

 suffered from diffuse cancer, like Schlatter's case, and here the 

 very small portion of the cardia that had remained healthy was 

 utilised for the suture, so that this may be regarded as an almost 



