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time, according as by its nature, it yields more or less readily to the 

 changes which it has to undergo. Gosse of Geneva, ascertained, by ex- 

 periments performed on himself, that the animal and vegetable fibre, con- 

 crete albumen, white and tendinous parts, paste containing fat or butter, 

 substances which have either not undergone fermentation, or which do 

 not readily undergo that process, remain longer in the stomach, offer 

 more resistance to the gastric juice, than the gelatinous parts of animals 

 or vegetables, fermented bread, Sec.; that the latter required but an hour 

 for their complete solution, while the former were scarcely dissolved, at 

 the end of several hours. 



XXI. The following case throws, I think, some light on the mechan- 

 ism and importance of the action of the stomach in digestion. The pa- 

 tient was a woman whom I had frequent opportunities of examining at 

 the " hopital de la charite," at Paris, in the clinical wards of Professor 

 Corvisart, in which she died on the 9tn Nov. of the year 1807, after six 

 months' stay in the hospital* 



A fistulous opening, of an oval form, an inch and a half in length, and 

 upwards of an inch in breadth, situated at the lower part of the chest, at 

 the upper and left side of the epigastric region, afforded an opportunity 

 of viewing the inner part of the stomach, which, when empty of food, 

 appeared of a vermilion colour, was covered with mucus, its surface 

 wrinkled over with folds about half an inch deep, and enabled one to dis- 

 tinguish the vermicular undulations of these folds, and of all the parts 

 which were in sight. The patient, who was then forty-seven years of 

 age, had this fistula since she was in her thirty-eighth year. Eigh- 

 teen years before, she had fallen on the threshold of a door, the blow 

 had struck against her epigastric region. The place remained affected 

 with pain, and she became incapable of walking or of sitting, otherwise 

 than bent forward and to the left side. At the end of this long interval 

 a phlegmonous and oblong tumour appeared on the injured spot : during 

 the nausea and vomiting which came afterwards, the tumour broke, and 

 there escaped at the wound, which was left by this rupture, two pints of 

 a fluid which the patient had just swallowed to obtain relief. From that 

 time, the fistula, which at first, would scarcely have admitted the tip of 

 the little finger, increased daily j at first it allowed only the fluids to pass, 

 but, on the eighth day, the solid food came away freely, and continued to 

 do so till she died. When admitted into the hospital, she ate as much as 

 three women of her age, she voided about a pint of urine, and went to 

 stool only once in three days. Her faeces were yellowish, dry, rounded, 

 and weighed more than a pound. Her pulse was very feeble and ex- 

 tremely slow, its pulsation scarcely exceeding forty-five or forty-six beats 

 in a minute. Three or four hours after a meal, an irresistible desire 

 obliged her to take off the lint and compresses with which she covered 

 the fistulous opening, and to give vent to the food which her stomach 

 might happen to contain; it came out rapidly, and there escaped at the 

 same time, and with a noise, a certain quantity of gases. The food thus 

 evacuated, exhaled an insipid smell, was neither acid nor alkaline, for, the 

 chymous and greyish coloured pulp into which they were reduced, when 

 suspended in a certain quantity of distilled water, did not affect vegetable 

 blues. The digestion of the food was far from being always complete ; 

 sometimes, however, the smell of wine could not be recognized, and 

 the bread formed a viscid, thick, and soft substance, similar to fibrine 



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