242 INTESTINAL DIGESTION. 



that the entire quantity of intestinal juice must be great, although beyond 

 this, no reliable estimate can be made. 



The intestinal juice is viscid and has a tendency to adhere to the mucous 

 membrane. It generally is either colorless or of a faint rose-tint, and its re- 

 action is invariably alkaline. 



With regard to the composition of the intestinal juice, little of a definite 

 character has been learned. All that can be said is that its solid constituents 

 exist in the proportion of about five and a half parts per hundred. In most 

 analyses of fluids from the intestine, there is reason to believe that the normal 

 intestinal juice was not obtained. 



The structures which secrete the fluid known as the intestinal juice are 

 the follicles of Lieberkuhn, the glands of Brunner and possibly the solitary 

 follicles and patches of Peyer. The secretion, however, is produced chiefly 

 by the follicles of Lieberkuhn. Although the other structures mentioned do 

 not contribute much to the secretion, they produce a certain quanity of 

 fluid ; and the intestinal juice must be regarded as a compound fluid, like 

 the saliva, and not as the product of a single glandular organ, like the pan- 

 creatic juice. 



Action of the Intestinal Juice in Digestion. The physiological action of 

 the intestinal juice has been studied in the inferior animals by Frerichs, Bid- 

 der and Schmidt and many others ; but their experiments have been some- 

 what contradictory. All are agreed, however, that this fluid is more or less 

 active in transforming starch into sugar. The observations of Busch, on 

 the case of intestinal fistula in the human subject, have given the most 

 satisfactory and definite information on this point. In many regards these 

 observations simply confirm those which have been made upon the infe- 

 rior animals, but they are of great value, as they establish many important 

 facts relating to the physiological action of the intestinal juice in the human 

 subject. 



The case reported by Busch was that of a woman, thirty-one years of age, 

 who, in the sixth month of her fourth pregnancy, was injured in the abdo- 

 men by being tossed by a bull. The wound was between the umbilicus and 

 the pubes, presenting two contiguous openings connected with the intestinal 

 canal. It was supposed that the openings were into the upper third of the 

 small intestine. At the time the patient first came under observation, every 

 thing that was taken into the stomach was discharged by the upper opening, 

 and all attempts to establish a communication between the two by a surgical 

 operation had failed. At this time the patient was extremely emaciated, had 

 a voracious appetite, and was evidently suffering from defective nutrition 

 resulting from the constant discharge of alimentary matters from the fistula. 

 Having been treated, however, by the introduction of cooked food into the 

 opening connected with the lower end of the intestine, she soon improved in 

 her nutrition and was then made the subject of extended observations upon 

 intestinal digestion. 



In this case, starch, both raw and hydrated, when introduced into the 

 lower opening, where it came in contact only with the intestinal juice, was 



