METHODS: (JASTRIC FISTULA. 



gastric fistula. In the year 1X42, the idea occurred to our countryman, 

 Professor Bassow,* and in the year 184:5, independently to the French 

 physician, Blondlot.f to reproduce artificially in animals a similar 

 condition to that observed by an American physician whose patient 

 suffered from the effects of a gunshot wound. After his recovery, a 

 permanent opening remained in the abdominal wall which led directly 

 into the stomach. They therefore made an opening through the dog's 

 abdominal wall into the stomach, and fastened into it a metal tube, 

 closed exteriorly by a cork stopper. The tube healed firmly into the 

 opening, and could remain for many years in position without causing 

 the least harm to the animal. 



This method raised great hopes at first, since it afforded, when 

 desired, easy and free access to the cavity of the stomach. But, as time 

 went on, the expectations gave place to disappointment, and for the 

 purpose of studying the action of the ferment of the gastric juice nearly 

 all investigators were obliged to employ an extract made from the 

 mucous membrane, since only very little and very impure gastric juice 

 could be collected from the fistula. It was likewise very difficult to 

 obtain any idea of the rate of flow during digestion, or of the properties 

 of the secretion under different conditions. Voices were, therefore, 

 loud in denunciation of the gastric fistula ; it had justified none of the 

 hopes, and had proved quite valueless. 



This condemnation was naturally exaggerated and was mainly 

 due to the vexatiously slow progress made in our knowledge of the 

 phenomena of secretion in the alimentary canal and especially in the 

 stomach. Why had not many important observations been made 

 earlier with the help of the gastric fistula ? It required only to be per- 

 fected by a slight modification, to enable fundamental questions to be 

 solved by its aid. 



In the year 1889, we (myself and Madam Schumow-Sirnanow>ki) 

 performed the operation of ocsophagotomy on a dog already possessing 

 a gastric fistula ; that is to say, we divided the gullet in the neck, and 

 caused both its divided ends to heal separately into an angle of the skin 

 incision. We thereby accomplished the complete anatomical separation 

 of the cavities of the mouth and stomach. Dogs so operated upon re- 

 cover perfectly with careful nursing, and live many years in the best of 

 health. In feeding, their food must naturally be brought directly into 

 the stomach. 



Witli such animals one can make the following interesting experi- 

 ment. If the dog be given flesh to eat the food drops out again from 

 the upper segment of the divided oesophagus. From the perfectly 



: ]l/iU,<t'ui (I,- In SKI', rfi'x .\titnr. dc Moxrtiu. T. xvi. 

 j Trait6 Analytique de la IHiji-xtion. 18-13. 



