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Physiology. — “On the intestinal juice of man”. Communication 
made by Prof. H. J. HAMBURGER from researches carried 
out conjointly with Dr. E. HEKMA. 
(Communieated in the meeting of March 29, 1902). 
Up to the present time only three investigations on the intestinal 
juice of man have been recorded; namely: those of DrMANT !) 
in 1879, of Tuppy and Mannine*) in 1892, and of Nagano ?) 
in 1902. 
Upon the whole these investigations have yielded few satisfactory 
results; they have failed to answer the question, what is the signi- 
ficance of the juice secreted by those hundreds of thousands of 
Lieberkühn’s glands, which everywhere line the inner surface of 
the intestine. 
When therefore Prof. Kocu directed our attention to the flow of 
intestinal juice, obtained from a lady with an intestinal fistula 
produced by an operation he had performed upon her, we did not 
hesitate for a moment to examine the juice secreted. We are 
extremely indebted to Prof. Koc, for his cooperation, and also for 
the interest with which he has followed our researches and for his 
readiness to comply with our wishes, after consulting the patient. 
In this respect we owe much also to Dr. P..M. E. Rogssinen, 
who always took the interests of the investigations to heart, besides 
those of his patient. 
The patient in question, was unmarried and 43 years of age; in March 1901 
she underwent a supravaginal amputation of the uterus, rendered necessary by 
a myoma uteri. When she was discharged from the Infirmary on the 27th of April, 
a suppurating fistula in the abdominal scar remained still open but it gradually 
closed. It reopened on the 5th July, discharging the liquid contents of the 
intestines. Soon afterwards, a similar discharge took place through the vagina. 
The patient became considerably weaker so that Prof. Kocu, as consulting phy- 
sician, advised another operation. This took place on the 15th of July. 
When the abdomen was opened a loop of intestine, grown together, was found, 
and fixed to this was a stercoral abscess. It seemed dangerous to clean this out. 
It was therefore decided, simply to separate the loop with the abscess from the 
rest of the intestinal canal; this was effected by cutting through the intestine at 
its entrance into the loop and at the other end where it came out; the ends were 
then united. The separated piece was ligatured at both extremities. Notwith- 
standing this the loop continued to discharge its contents in two places, namely, 
through the scar in the abdomen and through the vagina. At first the discharge 
1) B. Demant. Virchow’s Archiv. 75, 1879. S, 419. 
2) Tuppy and MANNING. Guy’s Hospital’s reports 48, 1892, p. 271. 
3) Nagano. Mittheilungen aus den Grenzgebieten der Medicin und Chirurgie 9, 
1902, S, 293, 
