210 STOMACH DIGESTION. 



portion of the food is rendered sufficiently liquid, it is liable to 

 pass out from the stomach, although there are other factors than 

 this liquid character of the food. If two different articles of food 

 were in the stomach at the same time, one might pass out from 

 that organ into the small intestine in one hour, while the other 

 might remain in the stomach two hours. From this fact alone one 

 would not be justified in assuming that the one substance was 

 twice as digestible as the other, for the former might not at the 

 time it left the stomach have been prepared for absorption, but 

 might require several hours for such a change after it reached 

 the small intestine ; while the latter, although it remained in the 

 stomach an hour after the former had left it, might at the time it 

 left the stomach have been in a condition to pass at once into the 

 blood. 



The practical use of tables showing the length of time that 

 different substances remain in the stomach seems to be to deter- 

 mine of what the food should consist when this organ is unable 

 to perform its function in a normal manner, and it is considered 

 wise to lighten its labors as much as possible. For this purpose 

 such food should be selected as will remain in the stomach but a 

 short time, even though it pass out in an undigested state, for, as 

 will hereafter be seen, the peptonizing function may be carried on 

 in the small intestine as in the stomach ; and in a disabled con- 

 dition of the latter organ, and even when this is absent, the former 

 will supplement it. In the dog, so thoroughly may digestion be 

 performed by the intestines alone, without the aid of the stomach, 

 that this latter has been almost completely removed, yet the animal 

 has been kept alive in excellent health and strength. The first 

 removal of this kind was by Czerny, and the dog lived for five 

 years. After death it was examined, and it was found that in 

 the operation all the organ had been removed except a small 

 portion of the cardiac extremity. The animal ate all kinds of 

 food and thrived on them. 



Trial-meals. Some light has been thrown on this question of the 

 duration of stomach digestion by the application of methods of 

 obtaining and examining the contents of the stomach for diagnostic 

 purposes. To ascertain how far the digestive process is interfered 

 with, trial-meals are given. The stomach is evacuated by means 

 of a soft-rubber stomach-pipe after a proper time, and inspection 

 shows to what stage the process of digestion has advanced. 



Hemmeter recommends the following plan of procedure : At 

 8 A.M. should be given one small piece of beef, scraped and 

 broiled == 80 gm. ; 1 soft-boiled egg ; 30 gm. of boiled rice ; 1 

 glass of milk = 250 c.c. ; and a piece of bread. Four or five 

 hours later an Ewald test-meal, consisting of a roll or a piece of 

 wheat bread and 500 c.c. of water, or tea without milk or sugar, 

 is given, and one hour after this the stomach-contents are drawn. 

 In giving a test-meal, Hemmeter recommends that good chewing 



