FUNCTIONS OF THE STOMACH. 297 



in the mouth produced a marked now of gastric juice. There 

 would seem to be no clear way of explaining the secretions in 

 these cases except upon the supposition that they were caused 

 by a reflex stimulation of the gastric mucous membrane through 

 the central nervous system." 



The Gastric Nervous Supply and the Formation of Gastric 

 Juice. When the nervous supply of the stomach is closely 

 examined, a rather unusual state of affairs presents itself: i.e., 

 it contains no lona fide motor nerves, unless we grant the many 

 sympathetic fibers distributed to it motor qualities, or, refusing 

 to recognize these, accept the vagus as the secretory nerve. 

 But, if we do this, to which nerve must we ascribe the afferent 

 impulses, which the ingestion of various substances that cause 

 nausea and other manifestations which clinicians so often wit- 

 ness induces? The sympathetic has everywhere shown itself 

 as an efferent nerve, and we have already furnished consider- 

 able evidence in favor of our view that all sympathetic nerves 

 are but subdivisions of the general motor system. Considered 

 from this standpoint, we could logically account for the phe- 

 nomena witnessed and relegate to the vagus the role of afferent 

 nerve which, judging from its recognized identity as a great 

 sensitive system, normally belongs to it. If, on the other hand, 

 we grant the vagus secretory functions, we have to transform 

 the sympathetic into an afferent nerve, and necessarily con- 

 trovert all the experimental evidence adduced. 



Howell, continuing the remarks quote'd above, says: 

 "These cases are strongly supported by some recent experi- 

 mental work on dogs by Pawlow and Schumowa-Simanowskaja. 

 These observers used dogs in which a gastric fistula had been 

 established, and in which, moreover, the oesophagus had been 

 divided in the neck and the upper and lower cut surfaces 

 brought to the skin and sutured so as to make two fistulous 

 openings. In these animals, therefore, food taken into the 

 mouth and subsequently swallowed escaped to the exterior 

 through the upper cesophageal fistula without entering the 

 stomach. Nevertheless, this 'fictitious meal/ as the authors 

 designate it, brought about a secretion of gastric juice. If in 

 such animals the two vagi were cut, the 'fictitious meal' no 

 longer caused a secretion of the gastric juice, and this fact may 



