REMOVAL OF THE HUMAN STOMACH. 213 



days attacks of vomiting recurred. One of these was about one 

 month after the operation, and an examination of the ejected 

 matter showed it to be acid in reaction, due to the lactid acid, no 

 free hydrochloric acid being found. Trypsin, bile-acids, and bile- 

 pigments were also found. 



From the time of the operation there was a continued increase 

 in weight, as shown by the following table : 



Table showing Weight of Patient after Operation. 



f . , . Actual weight in Increase in 



Date of weighing. grams? grams. 



October 5 33,600 



October 11 33,750 150 



October 18 35,260 1510 



October 25 35,500 240 



October 29 36,000 500 



November 5 36,200 200 



November 19 36,500 300 



December 3 37,500 1000 



December 9 37,500 



The patient was not actually weighed on the day of the opera- 

 tion, but the minimum increase from September 6 to October 5 

 has been estimated at 2000 gm. (2 kgm.). 



We cannot better conclude the history of this most remark- 

 able and interesting case than by quoting the conclusions of Dr. 

 Schlatter and Dr. Wendt. 



Dr. Schlatter says : 



" Clinical Observations in Connection with the Obliteration of 

 all Gastric Functions after the Operation. There being no food- 

 receptacle after ablation of the stomach, it became obligatory to 

 feed my patient at first with minute quantities of food, given at 

 short intervals. The results of this method of procedure were in 

 all respects happy ones. Quantities of food approaching ten ounces 

 seemed to excite vomiting. So, too, cold fluids resulted in diar- 

 rheal discharges, and may have been partly responsible for the rise 

 in temperature observed for some little time after the operation. 



" Keeping in mind the absence of mechanical function, the 

 patient's dietary was at first a strictly fluid one. But as early as 

 the second week after removal of the stomach semisolid and even 

 solid food was allowed. It was retained and digested without dis- 

 comfort. The patient having only a single tooth, mastication was, 

 of course, quite imperfect, otherwise it seems to me possible that 

 an ordinary mixed diet might have succeeded at a still earlier date. 



" Some weeks after the operation the patient's ordinary daily 

 dietary was as follows : At regular intervals of from two to three 

 hours she took milk, eggs, thin gruel or pap, tea, meat, rolls, 

 butter, and Malaga wine. The daily quantity amounted to one 

 quart of milk, two eggs, two to three ounces of pap or gruel, 

 seven ounces of meat, seven ounces of oatmeal or barley-water 



