934 



THE EXTERNAL SECRETIONS 



between the duct of Wirsung and the outside. CI. Bernard advocated 

 the use of a lead or silver cannula which he inserted in the orifice of this 

 duct and secured in the sides of the abdominal wound. A more con- 

 venient and permanent method has been devised by Heidenhain and 

 modified by Pawlow. It makes use of the fact that in the dog the 



Fig. 497. — Alveoli of Dog's Pancreas, Cells Loaded: Osmic Preparation. (Babkin, 

 Rvbasckin, and Ssawitsch.) 



lower duct is larger than the upper and has a well-defined orifice. 

 A quadrilateral piece of the intestinal wall immediately surrounding 

 this orifice is resected and is fastened in the sides of the abdominal 

 wound. The integrity of the duodenum must of course be reestab- 



FiG. 498. — Alveoli of Dog's Pancreas after a Period of Activity Produced by 

 Application of Acid to Mucous Membrane of Duodenum. (Babkin, Rubasckin, and 

 Ssawitsch.) 



lished before the latter is completely closed. Inasmuch as the pan- 

 creatic secretion possesses strong proteolytic properties, the external 

 wound must be kept dry and clean, otherwise erosions and infection 

 will result. * Furthermore, since the establishment of this fistula 

 prevents a large portion of the pancreatic juice from entering the 



