Basil C. H. Harvey 231 
Cade and Latarjet, 05, observed also a case in which these transforma- 
tions of ferment cells into mucous cells persisted for many years. An 
infant had had a gastric hernia which opened to the surface spontaneously 
during the first year of its life. The part of the stomach with which 
it communicated was later separated from the general cavity by strangu- 
lation of the hernia and constituted a separate gastric pouch. About 
the margins of the fistula by which this pouch communicated with the 
surface, the mucous membrane was found, after nineteen years, to 
contain glands derived clearly from fundus glands but containing large 
lumina and formed of a single layer of rather cubical cells which were 
in all essential points like pyloric gland cells. The walls of the small 
stomach were formed of normal fundus mucosa. In this case the fer- 
ment forming chief cells of the gland bodies had been replaced by mucous 
cells probably during the first year of life, and the mucous character 
had been preserved for nineteen years. But in both these cases of 
gastric fistula the conditions present are not those existing at a new 
pylorus formed by gastroenterostomy. 'The opening to the surface sub- 
jects the glands near it to irritation from garments, bacteria, friction, 
etc., and to excoriation from drying combined with friction, all cf which 
combine to produce a continued irritation which must tend to keep the 
glands affected in a condition of chronic inflammation, and so perpetuate 
in them phenomena which we have seen to be characteristic of inflam- 
matory conditions. 
In view of the subsequent reassumption by these cells, in my experi- 
ments, of their original function, after performing another function 
for several months, it seems necessary to believe that in the dog’s 
stomach the mucous transformation is not necessarily an irreparable, 
retrogressive change. 
And since such transformations are only temporary after simple 
incisions and after gastroenterostomies, it seems quite justifiable to 
conclude that they may be only temporary after inflammations from 
other causes also, that they are not necessarily degenerations nor even 
final differentiations, but are merely a passing stage of the cytomorphosis 
of these cells into which it is quite within their capacity to pass for 
months, and from which they may return to the assumption of their 
former characters and the performance of their former function. It 
should, therefore, be possible that in stomachs in which chronic inflam- 
mation has resulted in the change of ferment cells into mucous cells 
there may occur a changing back again of these same cells into ferment 
cells and a resumption of their original activity. This may serve to 
