442 v. MERING'S RESEARCHES. [BOOK n. 



narcosis and the operation, water was given to it. As it drank, water 

 flowed out of the stomach, but always rhythmically and in distinct 

 gushes. On introducing the finger, it was easy to feel that the 

 pylorus opened and closed at short intervals. Each minute, the 

 pylorus opened from two to six times, and each time expelled several 

 cubic centimetres (2 15) of water. The outflow occurred under 

 considerable pressure and lasted some seconds : then came a long 

 pause which was followed by another gush of water, and so on. By 

 this experiment the remarkable fact was established that (within a 

 few c.c., more or less) the whole quantity of water introduced into 

 the empty stomach flowed out of it. In accordance with the above 

 statement, it was found that an animal upon which such an operation 

 had been performed could not quench its thirst by drinking ; on the 

 contrary, the more it drank the more thirsty it appeared to be. This 

 fact is explicable by supposing that, in consequence of a small amount 

 of secretion occurring, the stomach actually lost water. 



By injecting 300 to 500 c.c. of warm milk three times daily into 

 the duodenal fistula, the animal could be fed and, for a few days, 

 appeared to enjoy perfectly good health. After a period, varying 

 between three and eight days, there supervened, however, a remark- 

 able association of symptoms : twitchings of the extremities and of 

 the facial muscles, the limbs became rigid, the teeth chattered, the 

 pupils often became dilated, and paralytic or paretic symptoms, with 

 constantly heightened tendon reflexes, made their appearance ; these 

 were soon followed by somnolence, deep respirations and, ultimately, 

 by death. This association of symptoms corresponds, v. Mering re- 

 marks, with those of the condition which Kussmaul described a 

 quarter of a century ago under the name of gastric tetany (' Magen- 

 tetanie ') and which has since been frequently observed and described 

 by Gerhardt, F. Mtiller, and others. 



As all the animals which had been subjected to the operative 

 procedure above referred to, died in the way described, v. Mering 

 next established a duodenal fistula, in close proximity to the pylorus. 

 Having made a suitable incision into the abdominal wall and drawn 

 out the stomach and duodenum, he fixed the duodenum at the spot 

 selected (5 8 cm. below the pylorus) to the wound in the abdominal 

 wall. With this object, 6 8 sutures were introduced which passed 

 through the serous and muscular coats of the intestine on the one 

 hand, and through the parietal layer of the peritoneum on the other. 

 After three or four days, the wall of the intestine enclosed between 

 the sutures was incised down to the mucous membrane, fresh stitches 

 being introduced through the serous and muscular coats. One or 

 two days afterwards, the mucous membrane was incised and the 

 communication with the interior of the gut established. During 

 each experiment, the passage downwards into the small intestine 

 was closed by means of a small caoutchouc bag distended with water. 

 In this second set of researches the results obtained by the first were 

 confirmed and extended. In one case, 500 c.c. of water being ad- 



