INTESTINAL JUICE. 325 



exhalation through the membranes of the follicles ; as there 

 is no evidence that their contents are discharged by rupture. 



Taking only into consideration experiments upon animals, 

 little definite information has been obtained concerning the 

 composition and properties of the intestinal juice. We can 

 readily see that this must be the case, since it has thus far 

 been impossible, in observations of this kind, to fulfil the 

 necessary physiological conditions. Further facts were evi- 

 dently needed to harmonize the opposite results arrived at 

 by different experimenters. It was the same in the progress 

 of the physiology of stomach-digestion, which was unsettled 

 and obscure until the normal gastric juice was obtained by 

 Beaumont. The case of intestinal fistula reported by Busch, 

 to which reference has already been made, has done much to 

 elucidate this subject. 1 



The case referred to was that of a woman, thirty-one years 

 of age, who, in the sixth month of her fourth pregnancy, 

 was injured in the abdomen by being tossed by a bull. The 

 wound was between the umbilicus and the pubes, presenting 

 two contiguous openings connected with the intestinal canal. 

 It was supposed that the openings were into the upper third 

 of the small intestine. At the time the patient first came 

 under observation, every thing that was taken into the stom- 

 ach was discharged by the upper opening, and all attempts 

 to establish a communication between the two by a surgical 

 operation had failed. At this time the patient was extremely 

 emaciated, had a voracious appetite, and was evidently suf- 

 fering under defective nutrition resulting from the constant 

 discharges of alimentary matter from the fistula. Having 

 been treated, however, by the introduction of cooked aliment- 

 ary substances into the opening connected with the lower 



1 BUSCH, Beilrag zur Physiologic der Verdauungsorgane. VIRCHOW'S Archiv, 

 Berlin, 1858, Bd. xiv., S. 140 et seq. An analysis of these observations, embra- 

 cing most of the interesting points, is contained in the American Journal of the 

 Medical Sciences, July, 1860, p. 217, and in the North American Medico- Chirur- 

 gical Review, of th same date. 



