On Intestinal Rest and Movement. 



229 



In the experiment quoted we see (1), vigorous propulsion accom- 

 plished by frequent repetition of contraction ; (2), more vigorous 

 propulsion accomplished by fewer, but more sustained contractions ; 

 and (3), the leisure and occasional movement of the intestinal tube 

 which would be favourable to active absorption. 



Direction of Propulsion of Bodies introduced into the Fistulous 

 Openings. 



The result of an examination of this question experimentally may 

 be given in few words. 



Peristaltic progression in the fistulous intestine is always in the 

 physiological direction. If the sound be placed well within the lower 

 mouth, it is invariably rejected from this mouth. Very occasionally 

 a sound introduced just within the upper mouth, but not far enough 

 to be thoroughly " gripped," may be expelled by the same opening, 

 but after it has passed 2 cm. into the fistula, this retrogression is 

 never seen. A slight anti-peristaltic movement observed on the 

 introduction of water into the fistula will be described below. 



Two Solid Bodies in the Fistula at the same Time. 



This experiment was performed with a double sound and register- 

 ing apparatus. The second sound, which was introduced after the 

 first had passed several centimetres into the fistula, was perforated 

 for the free passage of the thread connecting the latter with its pen. 

 It was found that the condition of peristalsis or local contraction was 

 not necessarily common to the whole length of the fistulous intestine, 

 and that therefore movement of one sound occurs frequently quite 

 independently of the other which lies within a few centimetres of it. 

 On several occasions a distinct alternation in movement was observed, 

 one sound resting whilst the other advanced. The first sound, i.e., 

 that nearest the lower opening of the fistula, seemed usually to travel 

 more rapidly than the other, and therefore to gain upon it. This 

 fact may speak for a slight stimulation originated by the presence of 

 the upper sound when at rest, favouring a more pronounced peri- 

 stalsis lower down the intestinal tube. Upon this point I am seeking 

 for further information. 



The introduction of water or almost any liquid, whether cold or at 

 the body temperature, into the upper end of the fistula through 

 which the sound had already passed, was invariably productive of 

 some slight anti-peristaltic movement often associated with writhing 

 or rolling of the intestine, the result being a retrogression of 2 or 

 3 cm. This reversed movement, which lasted for 2' to 5', was suc- 

 ceeded by a return of propulsive peristalsis which frequently showed 

 a marked acceleration. 



