the results of several experiments, which showed that this acid, in a diluted state, could only, at the most, exert one-fourth part of the solvent action on coagulated albumen which was exerted by the gastric juice itself. The neutral or alkaline gastric mucus of fasting animals dissolved only very slight quantities of albumen, but on adding hydrochloric acid the activity of the fluid was at once augmented. On neutralising the free acid of the gastric juice with potash, its digestive power is destroyed.

With regard to the effects of filtration, they observe that repeated experiments have convinced them that gastric juice from which all undissolved organic matters have been separated acts with the same efficiency as that which has not been filtered. This is obviously at variance with the view held by Frerichs, that new ferment continues to be developed from the cells contained in the gastric juice by the action of the free acid.

The experiments on concentrated and diluted gastric juice led to no definite result: indeed, no experiments seem to have been made with the concentrated fluid till it had been re-diluted with water.

It was proved by several experiments that the solvent action of the gastric juice is destroyed by rapid ebullition, or by evaporation at a boiling heat-an additional illustration of the well-known fact, that ferments are decomposed at an elevated temperature. This may possibly be the basis of the universally recognised dietetic rule, which declares all very hot foods or drinks to be injurious. On the other hand, the solidification of the gastric juice by artificial cold did not destroy its solvent powers-a circumstance which may be consolatory to those who are addicted to ices.

It was distinctly shown by three experiments, that the admixture of bile with the gastric juice-even when the quantity is so small that the mixture retains a distinctly acid reaction-completely destroys the solvent power of the latter secretion upon coagulated albumen.

The quantity of the gastric juice secreted in twenty-four hours was determined by Bidder and Schmidt, in the case of dogs, to be about one tenth of the whole weight of the body. Assuming the same ratio to be true for men, a man of ordinary weight (say from ten to twelve stone) would daily secrete no less than from fourteen to about seventeen pounds of this fluid. This is a very different estimate from that formed by Lehmann, whose calculations were based on the following data:100 grammes of the fresh gastric juice of a dog cannot, according to Lehmann's experiments, effect the solution of more than 5 grammes of coagulated albumen (calculated as dry).

An adult man receives into the stomach about 100 grammes of dry albuminous matter in twenty-four hours.

Hence, to digest this quantity, there must be secreted 2000 grammes, or four pounds of gastric juice.

We now proceed to the consideration of the bile-a subject to which Bidder and Schmidt have devoted much experimental labour.

The first question they consider is the following:-Is the bile to be regarded simply as an excretion? This point they have attempted to decide by observations on dogs in whom biliary fistula had been established.

A dog on whom this operation was performed lost two-fifths of its weight in thirty-four days, although its appetite was increased rather than diminished. The emaciation was especially marked both in the loss of fat and muscle. The hair fell off at many spots, or was loosened by the slightest touch. Digestion appeared to go on in an undisturbed manner, although the animal was in the habit of licking the bile as it escaped. The excrements had a greyish-yellow, and sometimes a partially green colour; but during the last few days of life regained their normal colour and odour. There were constant eructations of a bad odour, and the breath likewise had a very unpleasant smell. The urine was occasionally so concentrated, that its specific gravity was 1.050. The animal at length (on the thirty fourth day) died from general exhaustion. Dissection showed that a minute new ductus choledochus had become formed, probably between the twenty-first and twenty-fifth day after the operation, at which time the fistulous opening presented a tendency to contract. The right half of the stomach presented numerous ecchymoses, both of older and of more recent standing, although there were no symptoms of disturbed gastric

digestion during life-that is to say, there was no vomiting, and the appetite continued unimpaired. The rest of the intestinal tract presented nothing abnormal, except that it was of a somewhat deeper red tint than usual.

A second dog, similarly treated, did not present a voracious appetite, or exhibit the same amount of flatulence, or such a tendency to putrefactive decomposition as the former animal; but in the course of twenty-seven days (when it died) it had lost about one-half of its weight. Except that the fat and the muscles had almost disappeared, none of the organs were found to present any marked peculiarity.

Since the quantity of bile that escaped from the system in these two cases was not compensated for by the additional food that was taken, the idea suggested itself that the emaciation and the disturbed condition of the metamorphosis going on within the tissues might be due to the continuous drain upon the system. This view was confirmed by the two following experiments, in which this disturbing

cause was eliminated:

A dog, whose spleen had been extirpated, and in whom a biliary fistula had been established fourteen days afterwards, took such large quantities of food as more than to compensate for what was lost by the escape of bile. Its bodily weight, under these circumstances, did not materially diminish during the space of two months, at the end of which it was killed. The normal development and power of the muscles were retained, but the fat had gradually disappeared. Putrefactive decomposition of the excrements, and abundant flatus of a disgusting odour, were likewise observed in this case.

A very emaciated dog, whose spleen had not been extirpated, and in whom a biliary fistula had been established, regained its healthy appearance and its previous normal weight nineteen days after the operation. During this period it took more meat and bread than were requisite for it in its perfectly healthy condition. The ductus choledochus subsequently became re-established, and the weight then again. materially increased.

From these experiments, it seems clear that the question which they attempt to solve cannot be directly and positively answered either in the affirmative or the negative. By an artificial interference with the organism (by the establishment of a biliary fistula) the bile may be reduced, in a certain sense, to the condition of an excretion, if the loss thus occasioned to the system at large can be suitably covered. If this compensation be impossible, the derivation of the bile from the intestinal canal and its direct external discharge in a comparatively short time induce fatal emaciation and debility. For the full comprehension of the question in all its bearings, we should know the quantity of bile secreted in a given time and the average amount of solid constituents which it contains, the share which it takes in the process of digestion, the changes which it undergoes during and after its resorption into the blood, and lastly, the form in which it is finally eliminated from the organism.

In the strict sense of the word, we can hardly regard the bile as a digestive fluid. There is no special class of substances whose solution is dependent upon it. If, as certain experiments show, animals with biliary fistula can live even for years, the function of this fluid in digestion must, at all events, be a limited, and probably only an indirect one; and this is confirmed by the fact, that the secretion of bile does not attain its maximum till twelve or fifteen hours after food has been taken, when by far the greatest part of the ingesta must have passed beyond the duodenum; hence the greatest part of this fluid enters the small intestine at much too late a period to exert in it any great influence on the metamorphosis of the chyme.

[From trials upon various animals it has been ascertained that although the pancreatic juice exerts no solvent action in albuminous bodies, it yet acts with extreme power in converting starch into dextrine and sugar.]

Bernard, about four years ago, discovered that remarkable fact, that, externally to the organism, the pancreatic juice possesses the property of decomposing the neutral fats into their base and acid.

The only unquestionable action of the pancreatic fluid is that which it exerts on starch; but since the relative size of the pancreas is greater in carnivorous than in herbivorous animals (the weight of this gland being one-three-hundredth that of the whole body in dogs and cats, and only one-six-hundredth in that of rabbits), and since, further (as has been shown by Bidder and Schmidt's experiments), the greater part of the amylaceous food of the sheep is converted into sugar before it enters the

duodenum, we may fairly conclude that the principal uses of this secretion are still unknown.

There are far greater difficulties in obtaining pure intestinal juice than in procuring any of the secretions we have previously considered. The most recent investigations on this subject are those of Frerichs (contained in his article on Digestion), and of Zander (a pupil of Bidder and Schmidt's, who have themselves continued and extended his researches), and their conclusions are, upon the whole, very discordant.

All that we can say with certainty with regard to the physico-chemical properties of the fluid is, that after filtration it is a tenacious, ropy, colourless, and strongly alkaline substance.

According to Frerichs, the intestinal juice exerts no change on any of the ordinary elements of food. Protein bodies and gelatigenous substances remained perfectly unchanged; fat became disintegrated in the same manner as in all other viscid fluids; neither, according to Frerichs, does it exert any special action on starch. Hence he denies to the intestinal fluid any action as a direct digestive agent. Lehmann, on the other hand, found that the intestinal juice possessed, in a high degree, the power of converting starch into sugar; but protein bodies and fats were so little affected by it, that he doubts whether it exerts any digestive action on these substances, and the more so, since cubes of coagulated albumen and pieces of flesh, when introduced into the gut of a hospital patient through a fistulous opening, were expelled from the rectum almost entirely unchanged. The fistula was, however, in the lower part of the ileum, and probably near the cæcum. Finally, the results of experiments on nineteen cats and two dogs have convinced Zander and Bidder and Schmidt, that the intestinal juice exerts a solvent action on albuminons bodies, scarcely inferior to that of the gastric juice, and a sugar-forming power on starch scarcely inferior to that of saliva or of pancreatic juice.-Brit. and For. Med.-Chir. Review, July, 1853, p. 171.

45.-ON DEGENERATIONS OF THE GLANDULAR STRUCTURE OF THE STOMACH.

By DR. C. HANFIELD JONES, F.R.S., &c.

[It is somewhat singular that of all the writers who have expressed their opinions on the diseases of the stomach, none of them appear to have carefully investigated the changes occurring in its mucous membrane. And yet]

The mucous membrane of the stomach is a true gland structure, essentially different from that of the intestine; its follicles are not mere involucra of the surface, they possess a much higher function than that of merely secreting mucus. Examination

of a vertical section of the healthy tissue shows that in the greater part of its extent it is made up of parallel tubes ranged side by side, and so close together that there are scarcely any interspaces discernible. These tubes are nearly of the same size as, and altogether very similar to, those of the kidney; the chief difference is, that they are more filled with epithelium, and do not exhibit a distinct central canal. They terminate as they reach the corium of the mucous membrane by blind extremities, which are often bulged, and sometimes slightly branching. Above, they open into shallow fossulæ, which are well represented in Bowman and Todd's 'Physiology, vol. ii. p. 193. These fossulæ are lined by an epithelium consisting of columnar particles, while that which fills the tubes consists of nuclei imbedded in granulous matter, and very numerous large nucleated cells full of granulous contents. This gastric glandular epithelium differs from the renal in this important circumstance relative to the discharge of its function, that it does not remain, like the latter, attached to the basement membrane, the wall of the tube, but is thrown off and constitutes itself a part of the secretion. In the pyloric region, the fossulæ are very much deeper, and the entering tubes much shorter; while low villi, containing single capillary loops, spring from the partition walls of the fossulæ. In the other regions of the stomach there are no true villi, but a deceptive appearance is occasionally presented by papilloid masses of altered epithelium exuding from the tubes.

One morbid condition which is not uncommonly observed, is an atrophic state of the lower ends of the tubes and of their epithelium. The latter, then, consists of coarse granular matter, with a few stunted, starved-looking nuclei and cells which often contain oily molecules. The lower blind ends of the tubes are faintly marked, and sometimes are evidently tending to disintegrate; at the same time the interspaces between adjacent tubes were wider, as if some had already disappeared. In some cases the epithelium is altered, containing no healthy cells, but filling up the tubes with a coarse granular matter, while they themselves are not atrophied.

A fatty change in the epithelium is not uncommon, and in some degree is scarcely to be regarded as of pathological import. The lower ends of the tubes in our domestic animals are often quite opaque from the presence of much oil in the epithelium: there is, however, in such instances, no indication of wasting or breaking up of the tubes. Sometimes the glandular tissue seems to undergo what may be called true fatty degeneration: the tubes lose much of their natural aspect, and become converted into cylindrical tracts of granular matter loaded with oil drops. When the epithelium is in a fatty state, the inner surface of the stomach will often be found to be of a dead dull white colour; and it is rather remarkable that sometimes the change is confined to patches of varying extent, perfectly circumscribed. This change in the colour of the stomach is noticed by Andral as the result of chronic gastritis.

Together with a varying degree of atrophic change in the tubes themselves, there is often observed a remarkable alteration of the submucous tissue, or rather of the areolar tissue which forms a kind of corium to the mucous membrane. On viewing a vertical section, masses of nuclear particles are seen heaped up among the fibres, where they come in contact with the blind ends of the glandular tubes; these increase and advance upwards between the tubes, and occasion or coincide with their atrophy. The masses of nuclei are separated from each other, a certain space of healthy tissue intervening between them. The spots occupied by the nuclear deposits are sometimes depressed, so as to give rise to an appearance of open follicles. In an extreme instance the nuclear deposit has so increased as to cause almost a complete atrophy of the tubes, debris alone of which can then be discerned amid the altered intervening tissue. Vascular injection is by no means a constant accompaniment of this condition; and when it exists, it has not appeared to me at all clear that it was not of a passive kind. Together with the nuclei there is a certain quantity of granulous matter, which varies, however, in amount; it is not generally enough to conceal the nuclei.

Sometimes the exudation shows some tendency to the production of fibroid tissue, but I have never seen this developed in a very marked manner. Perhaps, however, contraction of the surrounding areolar tissue may have been the cause of the peculiar alteration observed in the following instance.

In a female, of thin and spare habit, who had been ailing two years, and who died of bronchitis with emphysema and dilatation of the heart, the liver was in a highly nutmeg state, and its Glissonian sheaths were considerably thickened; the kidneys were not healthy, and they contained reddish yellow pigment, the sign of former extravasations of blood. The mucous membrane of the stomach in the region adjoining the pylorus had a mammillated aspect, and was of a reddish brown colour. It was covered over with small, indistinct, sometimes whitish eminences, which were very apparent on a vertical section as whitish grain-like masses in the deeper parts of the mucous membrane. These masses consisted of tortuous tubes crowded and packed together, and filled with an epithelium consisting of small-sized cell particles containing oily molecules, and of free nuclei imbedded in abundant granular matter. The basement tissue of the tubes was distinct in the masses, but could not be traced upwards to the mucous surface. In fact, the convoluted tubes seemed quite destitute of any outlet for their contents. The masses were separate from each other, and were closely girt by layers of fibroid tissue which seemed to compress them. In their intervals there was no trace of tubes. The epithelium of the surface preserved its usual columnar form.

I subjoin further details of the examination of some instances of the degenerative changes in the gastric mucous membrane above described.

A pallid, ill-nourished female, aged 22, who had long suffered with epigastric uneasiness and bad digestion, died of phthisis and bronchitis. She had been fifty-one

days in the hospital, and had undergone the operation for ruptured perineum, which proved quite successful. The contents of the stomach were acid. Some portions of the mucous lining were of a dead white, and presented the appearance of numerous quasi-follicular orifices; the rest was of a faint reddish gray tint. There was no vascular injection anywhere. The white parts of the mucous membrane showed on a vertical section parallel rows of tubes filled especially at their deeper parts with oil-laden cells of very perfect form and great consistence; these cells contained oil dots, opaque and black (but not drops), imbedded in much granulous matter. Besides the cells, the contents of the tubes consisted of free nuclei and granulous matter. The tubes were not broken up; but every here and there the row was interrupted, and there was left an empty looking space, which was occupied either by remains of tubes atrophied and containing merely a faint granulous matter, or by a mass of nuclei only. In one section the tubes existed only at the upper half or two-thirds of the vertical extent of the mucous membrane, while at the lower they were atrophied and replaced by a mass of nuclei. It was these interruptions in the continuity of the tubes which gave the appearance of follicular orifices. In the pale unwhity portions of the mucous membrane the epithelium was much less fatty. A man, aged 63, died with empyema, the consequence of an accident which had fractured several ribs. The cornea presented distinct arcus seniles. There was but slight fatty change of the muscular fibres of the left ventricle. The kidneys were not quite healthy; there were cysts on their surface. The inner surface of the stomach was of a pale colour, rather uneven; the mucous mambrane to the eye was not much altered, but under the microscope the tubes were found to be extremely wasted, and in many parts quite lost, and replaced by a granular and fibrous tissue containing multitudes of ill-shaped nuclear particles. In some parts there were groups of convolutions and bulgings of the tubes, stuffed with an opaque granulous and oily matter. The atrophy of the tubes was extremely marked. There was fibrinous deposit in the spleen.

A female, aged 19, died with syphilitic phagedena of the genitals. The stomach presented a natural aspect, with the exception of some slightly raised spots of the size of a pin's head in the vicinity of the pylorus. These seemed to be produced by accumulations of epithelium in the fossulæ. The tubes in this part were in a normal state. In the mid-region of the stomach the tubes were much wasted, those remaining only contained a granulous and oily matter.

In a middle-aged female, dying with scirrhus pylori, the stomach was found distended to some extent; its muscular coat was much hypertrophied; its mucous membrane apparently healthy. On closer examination, the lower ends of the tubes near the pylorus were seen to be aggregated into bunches, while in other parts they were very indistinct, evidently atrophied, and surrounded by intertubular exudation, consisting of nuclei and granulous matter. In one section, two large cysts were seen, full of a transparent fluid, and lined by a delicate vesicular epithelium. They lay in the substance of the mucous membrane. The kidneys were granular and cysted. There was considerable fibroid thickening of the capsule of the spleen, and some also of that of the liver.

A man, aged 51, addicted to drinking, and subject to gout, died with double pneumonia, pleurisy, and pericarditis, after five days' illness. The kidneys were healthy. The stomach appeared markedly mammillated in its mid-region; it was not injected. The tubes appeared pretty natural, but were obscured by an interstitial exudation, developing itself into nuclei and granulous or perhaps indistinct fibroid matter: at one part there was a large nodular accumulation, consisting solely of nuclei. From this mass, the nuclear deposit extended in smaller quantity among the tubes, and would, at a later period, have no doubt occasioned their atrophy. The mucous membrane of the fundus was red and softened; but its tubes were quite natural and unobscured by any intervening exudation. The pyloric portion, like the cardiac, showed no trace of mammillation: there was, however, in this part very considerable intertubular fibroid formation, with infarction of the lower ends of the tubes by oily and granular matter, and gathering up of their lower parts into bunches. Many tubes in this part were also atrophied, so that a section no longer presented a continuous row.

In a female, aged 43, who died of uterine cancer, the mucous surface of the stomach was of a dead whity colour throughout. The tubes were not wasted, but were filled