Research into the chemical processes in the small intestine of man / by Allan Macfadyen, M.D. Ed., M. Nencki, M.D., and N. Sieber, M.D.
- Macfayden, Allan, 1860-1907
- Date:
- [1891?]
Licence: Public Domain Mark
Credit: Research into the chemical processes in the small intestine of man / by Allan Macfadyen, M.D. Ed., M. Nencki, M.D., and N. Sieber, M.D. Source: Wellcome Collection.
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![was always uncertain in what portion of the same the opening was, and to what degree and extent the food-mass might have been further altered in the portion of intestine below the fistula, An exact knowledge of the processes of digestion can be best obtained from the living subject, and it is of great importance to investigate separately the changes undergone by the food in the individual and anatomically different sections of the digestive tract. The knowledge thereby gained would be invaluable in the treatment of intestinal affections. It was considerations such as these that prompted us to undertake the following investiga¬ tion. We avail ourselves of this opportunity to thank Professor Kocher for directing our attention to the case, and to express our indebtedness to his assistant, Dr Lanz, for his kind help and the attention he paid to our wishes with regard to the patient. The patient, Magdalene Spycher, was a peasant woman, from Konitz, near Berne, sixty-two years old, thin, and of medium height. Her weight on admission was only 40 kilogrammes. She was received into the surgical wards on the 16th May 1890, and was operated upon on the same day. The subcutaneous cellular tissue was already partly necrotic; the hernia sac, with the portion of omentum contained therein, completely necrotic. The protruding coil of intestine was gangrenous. There was an oblong perforation in the intestine, and it was evident that the protruding coils were caecum and ileum. On account of the intense inflammation, it would have been dangerous to stitch the large and small intestine together. Accordingly the gan¬ grenous portions were removed, and an anus praeternaturalis estab¬ lished. The portion of small intestine excised was about 10 centimetres long, the portion of caecum about 3 centimetres long. The wound healed rapidly; and on the following day the patient felt better. There were no symptoms of peritonitis, and the temperature remained normal. A quantity of pulpy excrement was discharged from the fistula in the ileum. Three days later (the 19th) a hard stool passed per anum. From the ileum the discharge was diarrhoeic ; and tinct. opii was administered. The patient thereafter had a good appetite, and felt well. On the 4th of June, the discharge from the ileum, being again diarrhoeic, decoctum rhatanhise was administered, and the diarrhoea ceased. On the 5th of June the patient was put upon a diet chosen by herself. It was weighed daily, and consisted of the following items :— Bread, . . .260 grms. Peptone (Ke] mmerich), 20 grms. Meat, . . . 100 „ Sugar, . 60 5? with two eggs. Milk, . 100 J J Barley gruel, . . 200 ,, Bouillon, . 1050 This diet was given during the day as follows :— VOL. XXV. (N.S. VOL. V.) 2 D](https://iiif.wellcomecollection.org/image/b30799132_0005.jp2/full/800%2C/0/default.jpg)
