230 PHYSIOLOGY CHAP. 



ileum, below which (large intestine) it is nil, as already pointed 

 out in discussing the digestive secretions (see p. 128). 



Even more interesting from the physiological point of view is 

 the experiment in intestinal resection carried out on a bitch by 

 Monari and De Filippi (1892). They succeeded in keeping the 

 animal alive after extirpation of 1'90 m. of the small intestine. 

 During the first 13 days there was a progressive diminution in 

 weight, from which, however, the bitch recovered on a suitable 

 diet. Five months after the operation she was normally delivered 

 of 4 puppies, one of which was suckled for 3 weeks by the mother. 

 A year after the operation the animal was killed, when it was 

 found that only 25 cm. of the small intestine were left, i.e. 

 of the total initial length ! This observation shows that the 

 adaptability of the digestive functions is immense in a strong 

 subject, far in excess of what Senn and Trzebicky admitted. 



Surgical operations on man in which short lengths of the small 

 intestine are successfully removed are common. On the other 

 hand, there are very few cases on record in which the patient has 

 survived the resection of long tracts of the bowel. A woman on 

 whom Bourn operated in 1884, by removing 1*37 m. of the 

 intestine, died of marasmus in 4 months. Kocher in 1886 saw a 

 man in good health from whom he had removed T60 rn. of small 

 intestine. Four years later this patient showed no sign of gastro- 

 intestinal disturbances. In another with intestinal rupture from 

 a railway accident, Kocher removed 2'OS m. of small intestine. 

 The man recovered, but was subject to frequent diarrhoea. 

 Schlange in 1892 excised 1'35 m. small intestine in a female, who 

 was completely cured, with no sequelae from intestinal disturbance. 

 Trombetta (1883) operated on a woman suffering from sarcoma of 

 the small intestine. He cut away T10 m. along with the mesentery 

 and some hypertrophied lymph glands. The course of the malady 

 after this severe operation was favourable, and the patient was 

 cured. 



The case described by Euggi in 1896 deserves more detailed 

 consideration. This is perhaps the most classical experiment that 

 physiologists can bring forward in man, to demonstrate the great 

 functional adaptability of the intestine where the patient combines 

 the favourable conditions of strength, youth, and perfect health of 

 the viscera. In a boy of 8, who had a large wound on the 

 abdomen at the level of the umbilicus, Ruggi, after two preliminary 

 operations in the hope of averting intestinal stricture by simply 

 dividing the tissues, was obliged to perform a third operation 

 13 days after the second, the symptoms of intestinal stoppage 

 having again set in acutely. On making a large opening in 

 the abdomen, he saw that owing to an adhesive peritonitis the 

 greater part of the intestinal loops were knotted up into a huge 

 skein and could not be disentangled without freeing the loops 



