42 GASTRIC JUICE. 



we are in the next place indebted to Blondlot* for producing such 

 fistulous openings in dogs. I have not found the establishment 

 of these fistulse by any means so easy a matter as would be in- 

 ferred from Blondlot's description. A number of causes may 

 intervene to prevent the operation from terminating favourably. 

 Foremost amongst these, I may mention that the dogs generally 

 bite away the ligature and the plug to which the thread passing 

 through the stomach is fastened, and pull out the thread, so that a 

 rupture of the stomach ensues, which is perfectly certain to cause 

 the death of the animal; and the application of a starch bandage is 

 seldom of any use in preventing this mischief, unless the animal be 

 so securely tied that he cannot move himself. This cruel pro- 

 cedure must, further, be continued for some time, since the subse- 

 quent application of sponge plugs to dilate the fistula requires 

 equal precautions. Hence, as far as my own experience goes, I 

 can only recommend Bardeleben'st method of establishing such 

 fistulee, by which the above and many other objections to Blond- 

 lot's procedure are avoided. 



According to Bardeleben, the following is the best method of 

 proceeding. We make an incision two inches in length from the 

 ensiform process towards the umbilicus, exactly in the linea alba ; 

 after perfectly separating the abdominal walls, we open the peri- 

 toneum for an equal length, and with two fingers seize the stomach 

 (which, if the animal has been fed shortly before the operation, is very 

 easily accomplished) ; we then form a fold about an inch in length, 

 (in which we must take care that no large blood-vessels are run- 

 ning), pass a ligature through it with a strong needle, and fasten 

 the fold to a wooden peg placed transversely across the wound, 

 which must be closed by stitches passing of course through the 

 abdominal walls ; the fold of stomach must then be included 

 in the angle of the wound lying nearest to the navel, in order 

 that the thread shall not cut the fold in the violent movements 

 which accompany the vomiting that often ensues, and in which the 

 stomach is forcibly drawn inwards. Bardeleben lays it down as a 

 very important rule, that a doubled thread should be drawn 

 through the abdominal muscles and fold of stomach, and that the 

 two ends of one thread should be tied in front of the portion of 

 stomach thus artificially prolapsed, and those of the other behind 

 it. The wound then requires no further treatment (and this in 



* Trait^ analytique de la Digestion, consid^r^e particulierement dans 1'homm 

 et dans les animaux vertebres. Nancy et Paris, 1843. 

 t Arch. f. phys. Heilk. Bd. 8, S. 1-7. 



