OF THE ALIMENTARY CANAL 129 



It must not be supposed that rectal feeding 

 supplies absolute rest to the stomach. It may be 

 observ^ed in patients with a gastrostomy wound that 

 each nutrient enema excites a reflex flow of gastric 

 juice. 



Those who beheve in the possibility of feeding 

 patients satisfactorily by nutrient enemata usually 

 rely upon some incorrect published analyses by 

 Ewald, an observation by Leube that a dog can be 

 kept alive for many months by injections of chopped 

 meat and pancreas (this method causes toxic sym- 

 ptoms in man), and the remarkable fact that the 

 weight may be fairly well sustained at first. This 

 happens even if nothing but water is given, and is 

 due to the fact that the patients, usually sufferers 

 frorr haematemesis, are exsanguinated to start with 

 and greedily absorb water. Patients have been 

 kept alive on nutrients for several weeks, but it 

 is well known that there are sometimes sudden and 

 unaccountable deaths. It must not be forgotten 

 that if water is supplied life will usually be prolonged 

 for a month with no food at all, and in one instance 

 a man was alive after sixty-four daj^s of complete 

 starvation. If water also is withheld, death takes 

 place in about a week ; but a girl buried in an Italian 

 earthquake lived eleven days without either food 

 or drink. 



We conclude, therefore, that feeding with nutrients 

 composed of peptonized milk is sheer starvation, 

 but that better results may be obtained with 

 enemata composed of dextrose and long-pancreatized 

 milk. 



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