The knotting of a duodenal tube during biliary drainage, as reported by Dr. Russell S. Boles1 of Philadelphia, happened once under my observation. After the duodenal tube was supposedly in place, the injection of magnesium sulphate was made with great difficulty, there was no return flow of bile, and the patient felt a sense of discomfort. Therefore I withdrew the tube, which required considerable effort, and I found the distal end, about 6 inches from the metal tip, tied in a knot. A new tube was introduced, and after that the drainage was satisfactory.
Standardizing the Hormone.
—The physiologically important hormone stored in the gland must be sufficiently stable to resist the necessary chemical processes of making the gland extract; and, for practical organotherapy, the hormone must resist the action of the digestive enzymes and must be absorbed into the blood in active form. The hormone
Niles GM. KNOTTING OF DUODENAL TUBE DURING BILIARY DRAINAGE. JAMA. 1924;82(12):967. doi:10.1001/jama.1924.26520380005012f
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