I NFL UENCE OF NER VO US S YSTEM. 5 3 7 



Since this time many other cases of gastric fistula in the human subject 

 have been under observation. 1 In 1842, Bassow 2 and Blondlot simultaneously 

 introduced the method of obtaining gastric juice by an artificial fistula in an 

 animal, and this method was further developed by Heidenhain, 3 who introduced 

 antiseptic precautions into the operation. 



Heidenhain also succeeded in so developing Klemensiewicz's method of 

 isolating one portion of the stomach from the rest, that it was possible to keep 

 the animals under protracted observation in this condition. In making the 

 incisions for the operation, Heidenhain interfered as little as possible with 

 the more important blood vessels, but he apparently produced some disturb- 

 ance as far as the connections of the main nerves of the stomach were 

 concerned. 



Pawlow's 4 method of isolating by operation a portion of the stomach, 

 retained the advantages of that of Heidenhain, while keeping unimpaired 

 the nerve distribution to the isolated portion. 



The influence of the nervous system on gastric secretion. 



The stomach is supplied with two sets of nerve-fibres, cerebro-spinal 

 and sympathetic. The vagi constitute the cerebro-spinal set, and branches 

 from the solar plexus the sympathetic. The fibres of the vagi are almost 

 entirely noii-medullated in their course over the stomach. Plexuses 

 formed by these nerves lie between the muscular and in the submucous 

 coats. The nerve-fibres are distributed to the muscular tissue, to the 

 blood vessels, and to the mucous membrane, and filaments have been 

 traced to terminal arborisations between and in close contact with the 

 cells of the gastric glands. 5 



Many have attempted to obtain indications of the nature of the 

 impulses passing along these nerves by artificial stimulation. 



Kutherford 6 cut the vagi during digestion, and found that the mucous 

 membrane became paler. If the peripheral ends were stimulated, no 

 regular effect resulted ; if the central ends were stimulated, the mucous 

 membrane became redder. After division of both vagi, apparently 

 normal gastric juice was still secreted. Rutherford also found that 

 normal secretion occurred after division of the splanchnics. The effect 

 on the blood supply of stimulation of the central end of the vagus was, 

 presumably, brought about by impulses passing to the medulla oblongata, 

 inhibiting the action of the vasomotor centre there, and resulting in 



1 The following is a list of the principal observations on gastric fistulte in man : 

 Helm, "Zwei Krankengeschichten," Wien, 1803; Briicke's " Vorlesungen, " Bd. i. S. 

 300; Beaumont (1825-33), "Experiments and Observations on the Gastric Juice and the 

 Physiology of Digestion," reprinted from the Plattsburgh edition, with notes by Andrew 

 Combe, M.D., Edinburgh, 1838 ; W. Robertson, 1851 ; C. Schmidt, Diss., Dorpat, 1851 ; 

 Ann. d. Chem., 1854, Bd. xcii. ; Kretschy, Jahresb. ii. d. Fortechr. d. Thier-Chcm., 

 Wiesbaden, 1876, Bd. vi. S. 173 ; Uffelmann, ibid., 1877, Bd. vii. S. 273 ; Richet, " Le sue 

 gastrique," Paris, 1878. 



2 The following is a list of the more important observations on gastric fistulte in 

 animals : Bassow, Bull. Soc. imp. d. nat. de Moscou, 1842, tome xvi. ; Blondlot, "Traits' 

 aualytique de la digestion," Nancy et Paris, 1843; Bardeleben, Arch. f. physiol. Heilk., 

 Stuttgart, 1849, Bd. viii. ; Bidder u. Schmidt, "Die Verdauungssafte," Leipzig, 1852; 

 Holmgren, Jahresb. ii. d. Leistwig. . . . d. ges. Med., Berlin, I860, Bd. i. ; Schiff, " Le9ons 

 sur la physiologic de la digestion," Paris and Berlin, 1867, Bd. i. S. 15 ; Klemensiewicz, 

 Sitzungsb. d. Jc. AJcad. d. Wissensch., Wien, 1875, Bd. Ixxi.; Panum, Jahresb. ii. d. 

 Fortschr. d. Thier-Chem., Wiesbaden, 1878, Bd. viii. S. 193; Heidenhain, Arch. f. d. ges. 

 Physiol., Bonn, 1878, Bd. xviii. S. 169 ; 1878, Bd. xix. S. 148 ; Hermann's "Handbuch," 

 Leipzig, 1881, Bd. v. S. 107. 



* " Anlegung von Magenftsteln," Hermann's "Handbuch," Leipzig, 1881, Bd. v. Th. 1. 



4 The details of this method are described by Chischin, Inaug. Diss., St. Petersburg, 1894. 



5 Kytinanov. Internal. M onatschr. /. Anat. u. Physiol., Leipzig, 1896, vol. xiii. p. 402 



6 Trans. Roy. Soc. Edin., 1870, vol. xxvi. 



