406 THIRY'S INTESTINAL FISTULA. [BOOK n. 



deprived of food (Tiedemann and Gmelin 1 , Bidder and Schmidt 2 ), 

 or isolated loops of intestine in living animals by ligatures and, 

 having replaced them, in the abdominal cavity, for a period of 4 6 

 hours, examined the fluid which had accumulated and which they 

 took to represent the normal intestinal secretion (Frerichs) 3 . If we 

 except the observations made on some cases of intestinal fistula in 

 man, especially those of Busch and Demant, our knowledge of the 

 intestinal juice has been obtained almost entirely by the aid of the 

 experimental methods devised by Thiry and by Vella. 



Thiry 4 conceived the remarkably ingenious idea of 

 Thiry s fistula. , , . J f . , ,, \, ,, . . . . 



isolating a portion from the rest of the small intestine, 



and establishing a fistulous aperture between the isolated piece and 

 the abdominal wall. An incision having been made in the lined 

 alba of a fasting dog, and the abdominal cavity having been opened, 

 a coil of intestine is drawn out, and is carefully cut across at points 

 10 to 15 cms. distant from one another, care being taken that no 

 large vessels pass between the intestine and the mesentery where 

 the incisions are made. Avoiding injury to the mesentery, the 

 upper and the lower ends of the intestinal tube, from which the 

 above segment has been eliminated, are now most carefully united 

 by interrupted sutures, the continuity of the alimentary canal being 

 thus re-established. The second part of the operation now com- 

 mences. One end of the resected intestine is closed by a series of 

 sutures ; the other end is then stitched to the upper or the lower 

 end of the incision in the abdominal wall. Thus is established 

 a cul de sac communicating with the exterior of the body, and 

 the walls of which are composed of intestinal mucous membrane. 

 Although Thiry's operations were performed without antiseptic 

 precautions, recovery occurred in several cases. Under our present 

 conditions, if performed by a competent operator, the operation would 

 almost invariably result in the recovery of the animal. 



VeUa's double Thiry's original operation has been abandoned in 

 fistula. favour of an ingenious modification first devised and 



carried out by Vella 5 . As the procedure is one of great practical 



1 Tiedemann and Gmelin, Die Verdauung nach Versuchen, Vol. i. pp. 102 103 and 

 pp. 154162. 



2 Bidder and Schmidt, Die Verdauungssdfte und der Stoffwechsel, Mitau und 

 Leipzig, 1852, p. 260 et seq. 



3 Frerichs, article ' Verdauung ' in Wagner's Handworterbuch d. Physiologie, Vol. in. 

 p. 851. 



4 Thiry, ' Ueber eine neue Methode, den Dunndarm zu isolieren.' Sitzungsber. d. 

 Wiener Akademie, Vol. L. (1864), p. 77. 



5 Ludwig Vella, 'Ein neues Verfahren zur Gewinnung reinen Darmsaftes und zur 

 Feststellung seiner physiologischen Eigenschaften,' Moleschott's Untersuchungen, VoL 

 xin. (1881), p. 40; 'Nouvelle methode pour obtenir le sue ent<rique pur et pour 

 en fixer les propri6t6s physiologiques (K6sume),' Archives Italiennes de Biologic, Vol. i. 

 (1881), p. 228. The first paper, which the Author has not seen, was entitled 

 'Nuovo metodo per avere il succo enterico puro e stabilirne le proprieta fisiologiche,' 

 Memorie dell' Accademia delle Scienze delV Istituto di Bologna, Ser. 4, Tom. n. 

 Fasc. 3. 



