Demonstration of a Dog Maintained for Sixteen Weeks Solely by Jejunal Alimentation in the Presence of Loss of Gastric Juice.

In order to answer certain questions relative to the general problems of gastric secretion and intestinal obstruction, some method of maintaining dogs indefinitely by jejunal alimentation was desired. Also, the clinician is not infrequently confronted with the question of the proper method and pabulum to use in certain jejunostomy cases. The difficulty that is generally encountered in attempting to feed animals and man via a jejunostomy is that diarrhea and enteritis are so likely to occur.

Obviously, such a method should consist, first, of a bland, nonirritating, easily digested pabulum containing all the essential food elements and, second, it should be administered slowly, simulating the manner of emptying of the stomach. It might be thought that the pabulum should be predigested with gastric juice and pancreatin and glucose added. We have tried this a number of times, but have found that such a mixture was irritating to the bowel.

After considerable preliminary experimentation on jejunal fistula dogs, a pabulum was found by one of us (H. G. Scott) which was bland and non-irritating. It consists of the following elements: water, 3000 cc.; whole milk, 3000 cc.; flour, 300 gm.; cane sugar, 150 gm.; peptone, 100 gm. The mixture is cooked, giving attention to certain details which will be given in a later, more complete paper (pH 6.0). Four hundred cc. of the mixture is fed 3 to 5 times in 24 hours diluted with 200 cc. of tap water.

When the jejunal feedings are first started the intestine will not tolerate 600 cc., but smaller quantities must be given more frequently. To each feeding 1 gm. of pancreatin is added. From 6 to 10 gm. of salt are added per day to maintain a normal level of blood chlorides.