72 THE OBSERVATIONS OF BEAUMONT. [BOOK II. 



The facilities afforded by Beaumont's patient for systematic 

 observations on gastric digestion will be appreciated by a perusal 

 of the following quotations : 



" The valve, mentioned above, is formed by a slightly inverted portion 

 of the inner coats of the stomach fitted exactly to fill the aperture. Its 

 principal and most external attachment is at the upper and posterior edge 

 of the opening. Its free portion hangs pendulous, and fills the aperture 

 when the stomach is full, and plays up and down, simultaneously with the 

 respiratory muscles, when empty.*' 



" On pressing down the valve, when the stomach is full, the contents 

 flow out copiously. When the stomach is nearly empty and quiescent, 

 the interior of the cavity may be examined to the depth of five or six 

 inches, if kept distended by artificial means, and the food and drinks may 

 be seen entering it, if swallowed at this time, through the ring of the 

 oesophagus. The perforation through the walls of the stomach is about 

 three inches to the left of the cardia, near the left superior termination 

 of the great curvature. When entirely empty, the stomach contracts upon 

 itself, and sometimes forces the valve through the orifice, together with 

 an additional portion of the mucous membrane, which becomes completely 

 inverted, and forms a tumour as large as a hen's egg. After lying on the 

 left side, and sleeping a few hours, a still larger portion protrudes, and 

 spreads out over the external integuments, five or six inches in circum- 

 ference, fairly exhibiting the natural rugae, villous membrane, and mucous 

 coat lining the gastric cavity. This appearance is almost invariably 

 exhibited in the morning, before rising from his bed 1 ." 



*********** 



" Mode of extracting the Gastric Juice. The usual method of extracting 

 the gastric juice, for experiment, is by placing the subject on his right 

 side, depressing the valve within the aperture, introducing a gum-elastic 

 tube of the size of a large quill, five or six inches into the stomach, and 

 then turning him on the left side, until the orifice becomes dependent. 

 In health, and when free from food, the stomach is usually entirely empty, 

 and contracted upon itself. On introducing the tube, the fluid soon begins 

 to flow, first by drops, then in an interrupted, and sometimes in a short 

 continuous stream. Moving the tube about, up and down, or backwards 

 and forwards, increases the discharge. The quantity of fluid ordinarily 

 obtained is from four drachms to one and a half or two ounces (from about 

 14 to 56 grammes), varying with the circumstances and condition of the 

 stomach 2 ." 



We shall have, in the sequel, to refer again and again to this 

 very remarkable case, the observation of which proved so fruitful to 

 science, merely remarking that no case of gastric fistula, whether 

 established in man or the lower animals by accident, disease, or by 

 the experimenter's knife, has ever afforded such admirable opportu- 

 nities for study, for it occurred in a man of remarkable health, 

 ' active, athletic and vigorous, exercising, eating and drinking, like 



1 Beaumont, Op. cit., p. 23. 



2 Ibid., p. 22. 



