DIGESTION. 191 



the power of slowly transforming starch-paste into glucose, and that it 

 could emulsify oily substances with considerable energy. Bernard found 

 the same properties in a fluid obtained from the dog, by opening the 

 small intestine after some days' fasting. But on the whole these results 

 have not been very satisfactory, owing to the doubt how far the fluids 

 obtained represent the normcl secretion of the intestine. 



Furthermore, two instances of intestinal fistula have been observed 

 in man. In the case examined l^ Busch,* the patient, a woman, 31 

 years of age, had been ~crod by r, ctcer ; causing a fistulous opening in 

 the abdominal wall, midway between the umbilicus and the pubis. It 

 communicated with the small intestine very near its upper extremity, 

 the two portions of intestine being completely separated from each other 

 at the fistula, The portion of intestine below the fistula, accordingly, 

 contained none of the fluids from cJbovc, but only its own secretion. 

 Buscli operated by introducing into the lower portion of the intestine 

 various alimentary substances, and ascertaining how far they were 

 liquefied and absorbed. He concluded that there was a perceptible, 

 but not very energetic, solvent action on albuminous matters, a much 

 stronger one on starchy substances, and either very little or none at all 

 on fat. 



The case of Demantf was somewhat similar, except that the fistu- 

 lous separation between the two portions of small intestine was near 

 its lower instead of its upper extremity. It was the result of an opera- 

 tion for strangulated hernia in a man forty-two years of age, and at 

 the time of the observation in good health and condition. Demant col- 

 lected the fluids secreted by the lower portion of the intestine, and ex- 

 perimented with them on different kinds of food by artificial digestion 

 at the temperature of 36 to 38 C. He found the intestinal juice 

 very scanty, exuding from the fistula usually in drops. The largest 

 quantity obtained was 25 cubic centimetres per day ; the average from 

 15 to 20 cubic centimetres. It was a thin, clear, alkaline fluid, not 

 coagulable by heat, but precipitable by acetic acid owing to its mucous 

 ingredients. It contained no pepsine ferment, had no transforming 

 action on albuminous matters, and produced no peptone from coagu- 

 lated fibrine, even after a digestion of twelve hours. It slowly trans- 

 formed starch paste into glucose, requiring five hours' time for that 

 purpose. Oily matters, containing free fatty acid, were emulsioned by 

 it, but it had no perceptible effect on neutral fats. 



From these observations it appears that the intestinal juice cannot 

 be an abundant secretion, nor a very active agent in the digestive 

 process. It is an alkaline fluid, with a moderate transforming action 

 on starchy matters, much inferior to that of the pancreatic juice. Its 



*Archiv fur pathologische Anatomic und Physiologic. Berlin, 1858, Band xiv., 

 p. 140. 



f Archiv fur pathologische Anatomic und Physiologic. Berlin, 1879, Band Ixxv., 

 p. 419. 



