n, 4 1/2 feet; Stanley, three feet; Tremaine,
17 inches; and Grossoli, 40 cm.

Rupture of the Intestines.--It is quite possible for the intestine to
be ruptured by external violence, and cases of rupture of all parts of
the bowel have been recorded. Titorier gives the history of a case in
which the colon was completely separated from the rectum by external
violence. Hinder reports the rupture of the duodenum by a violent kick.
Eccles, Ely, and Pollock also mention cases of rupture of the duodenum.
Zimmerman, Atwell, and Allan report cases of rupture of the colon.

Operations upon the gastrointestinal tract have been so improved in the
modern era of antisepsis that at the present day they are quite common.
There are so many successful cases on record that the whole subject
deserves mention here.

Gastrostomy is an operation for establishing a fistulous opening in the
stomach through the anterior wall. Many operations have been devised,
but the results of this maneuver in malignant disease have not thus far
been very satisfactory. It is quite possible that, being an operation
of a serious nature, it is never performed early enough, the patient
being fatally weakened by inanition. Gross and Zesas have collected,
respectively, 207 and 162 cases with surprisingly different rates of
mortality: that of Gross being only 29.47 per cent, while that of Zesas
was for cicatricial stenoses 60 per cent, and for malignant cases 84
per cent. It is possible that in Zesas's statistics the subjects were
so far advanced that death would have resulted in a short time without
operation. Gastrotomy we have already spoken of.

Pyloroplasty is an operation devised by Heineke and Mikulicz, and is
designed to remove the mechanic obstruction in cicatricial stenoses of
the pylorus, at the same time creating a new pylorus.

Gastroenterostomy and pylorectomy are operations devised for the relief
of malignant disease of the pylorus, the diseased portions being
removed and the parts resected.

Gastrectomy or extirpation of the stomach is considered by most
surgeons entirely unjustifiable, as there is seldom hope of cure or
prospect of amelioration. La Tribune Medicale for January 16, 1895,
gives an abstract of Langenbuch's contribution upon total extirpation
of the stomach. Three patients were treated, of whom two died. In the
first case, on opening the abdominal cavity the stomach was found very
much contracted, presenting extensive carcinomatous