DIGESTION IN THE STOMACH 293 



Attempts have been made to determine the digestibility of different articles 

 of diet and dishes by subjecting the stomach contents obtained from fistulous 

 patients or from healthy individuals by means of the stomach tube, to investi- 

 gation at certain intervals after eating. But it has been shown that in the same 

 person the same food on different occasions requires a very different time for 

 its formation into chyme. A presentation of these results would call for a dis- 

 cussion of a mass of details which would be out of place here. Besides, the 

 fact just stated has lost much of its strangeness in view of the recent contribu- 

 tions on the conditions of secretion in the stomach (page 263). 



Nevertheless, the following- general principles as to the digestibility of a diet 

 in the stomach may be laid down : 



(1) A too voluminous meal is harmful to the stomach; for in order that it 

 may be properly saturated with gastric juice, a very copious secretion i.e., a 

 great effort on the part of the gastric glands is required, and in order to knead 

 and mix it thoroughly, an unusual demand is made upon the stomach mus- 

 culature. 



(2) Poorly masticated or very compact food will likewise call for too great 

 an effort on the part of the stomach ; for the larger and more compact the pieces 

 swallowed, the longer will be the time required to saturate them with gastric 

 juice and dissolve them. 



(3) Animal foods which are tough e. g., meat from old, poorly nourished 

 animals are difficult to chew, and offer great resistance to the action of the 

 stomach. The looser and more porous the food, the more easily is it digested 

 in the stomach; a sick or weakly stomach, therefore, receives best a soft or 

 gruelly food. 



(4) Fat in the food has a great influence, 1 partly through its inhibitory action 

 on the glands of the stomach. But not only so; if it permeates the food thor- 

 oughly, it forms a kind of protective film, which prevents the entrance of the 

 gastric juice to the proteid or gelatin constituents. This is especially true if 

 the fat eaten be not fluid at the body temperature. 



(5) Strong spices, alcohol, etc., act unfavorably on digestion in the stomach, 

 partly because, as with alcohol in great concentration at least, they reduce the 

 action of the gastric juice on the food in some way or other, 



(6) Digestion in the stomach is influenced also by other circumstances than 

 the character of the food. Thus the digestive power of the gastric juice is 

 reduced for a time by intense sweating, since both the HC1 and the absolute 

 quantity of the secretion are thereby diminished. Again exhaustion from intense 

 muscular work causes a decrease in the quantity of gastric juice, which becomes 

 thick, ropy and strongly mucous. It has even been observed that stomach diges- 

 tion ceases entirely under heavy muscular work. 



Since the function of the stomach is to change the food into a semifluid or 

 gruelly mass, one might suppose a priori that the stomach could be dispensed 

 with entirely, if the food taken were already of this gruellike nature. And this 

 is in fact the case. The stomach has been successfully removed from dogs 

 (Czerny), cats, and even from men suffering from carcinoma of the stomach, 

 without endangering life or preventing digestion. It is only necessary to admin- 

 ister food in small portions and in a very finely divided state in order to main- 

 tain life as usual. 



Our knowledge of gastric digestion and related phenomena show there- 

 fore that the essential function of the stomach, aside from the antiseptic 



1 See also page 285. 



