ASTHENIA OF THE GASTRIC GLANDS. 175 



its turn makes matters worse. But if each time, before the feeding, 

 the normal psychic excitant of the gastric glands (which is now absent) 

 be replaced by a chemical stimulant, and the stomach be freed, by 

 systematic washing out, from the remnants of the previous meal, 

 the difficulties are soon overcome, and a tolerably good condition 

 restored. I should like here to transgress the narrower bounds of my 

 subject, and once more expressly state,* that the question of the 

 survival of dogs after vagotomy, which has been for so long a matter of 

 uncertainty, has at length been answered in the affirmative by physio- 

 logy, and this result is solely to be ascribed to the fact that the causes 

 of the disturbances which set in after the operation, have been sub- 

 mitted to an exhaustive physiological analysis. In this, we have a 

 striking instance of a rational therapy, founded upon laboratory know- 

 ledge, directed against a severe and fatal lesion of the organism, pro- 

 ducpd also, it is true, in the laboratory. Thus, if a gastric fistula be made 

 in the dog, and its digestion regulated as above indicated (the cavities 

 of the mouth and stomach having been severed by means of an oesopha- 

 gotomy so as to prevent the gastric contents from passing along the 

 gullet into the lungs, should vomiting occur), a double vagotomy in the 

 neck ceases to have a fatal effect. Indeed, the operation is consistent 

 with long life and an excellent condition of health. (Experiments of 

 Prof. J. P. Pawlow and Dr. P. E. Katschkowski.) 



We may return once more to digestion. In a series of dogs with 

 well-marked hypersecretion, arising from spontaneous illness, or set 

 up intentionally, we have used alkalies (a |- per cent, solution of 

 sodium bicarbonate) by way of treatment. The result was that we 

 had the satisfaction of seeing the mode of action of alkalies, which I 

 explained five years ago to this esteemed assembly, fully confirmed. 

 It is one differing greatly from the current belief, which still holds 

 sway in the clinic, with regard to the effect of these substances. In all 

 the cases observed by us (Prof. J. P. Pawlow and Dr. J. C. Soborow) the 

 hypersecretion proved to be readily amenable to the influence of alkalies. 

 It diminished markedly, and the greatly exalted excitability of the 

 glands was fully and permanently set aside. 



It is to be observed that, with the experimental establishment of 

 asthenia of the gastric glands, the indications for a rational employment 

 of alkalies have been still further accentuated. In the irritable debility 

 of the cell that is to say, in the state of increased excitability which 

 soon leads to exhaustion alkalies, with their inhibitory effects, are 

 more than ordinarily suitable. But naturally the mechanism of the 

 alkali influence has still to be physiologically analysed. 



* The author had already made several communications dealing with these 

 investigations. 



