INFECTIONS OF THE DIGESTIVE TRACT 341 



The pyloroplastic operations have also frequently been 

 followed by striking benefit in chronic conditions. 

 Even in cases where an operation is done, not so much 

 for dilatation of the stomach as for a spastic or hyper- 

 trophic condition at the pylorus, the improvement may 

 have been associated with a diminished excretion of the 

 ethereal sulphates. I recall one case in which the 

 ethereal sulphates had regularly run far in excess of 

 the normal but in which this excess promptly disap- 

 peared after a pyloroplastic operation done for the relief 

 of a gradually increasing stenosis of the stomach as- 

 sociated with hyperchlorhydria and periodical seizures 

 of vomiting. Here the relief from putrefactive decom- 

 positions was probably merely one incident of ameliora- 

 tion of more acute and pressing conditions. Looking at 

 the pyloroplastic and similar operations from the stand- 

 point of chronic putrefactive intestinal disorders, one 

 has to admit that the indications for such operations are 

 at present not entirely clear. 



The operations to which reference has just been made 

 are designed to secure the prompt emptying of the 

 stomach into the small intestine. An entirely different 

 type of operation and one which has as yet been seldom 

 performed relates to the attempt to exclude a portion of 

 the large intestine. The fact that the large intestine 

 is the seat of some of the most distressing derangements 

 associated with putrefaction strongly suggests the pos- 

 sibility that these putrefactive disorders maybe mitigated 

 by surgical procedures which have for their aim the 

 elimination of a portion of the colon. Operations with 



