It has never been entirely clear that a failure of saliva to reach the stomach, owing to complete stenosis or to fistula of the esophagus, is of itself incompatible with normal growth, although such a possibility has been suggested by more than one author. Chevalier Jackson1 noted the clinical benefit to patients with esophageal stenosis of their adding saliva to their food by preliminary chewing. In a personal communication Prof. A. J. Carlson mentioned a child with complete obstruction of the esophagus who was undoubtedly helped by a regimen of mastication of food before its introduction into the gastrostomy tube by which she was fed. Carlson ascribed the rapid gain in weight which he observed mainly to the secretion of gastric juice accompanying appetite and the chewing reflex, and questioned the importance of the actual presence of saliva in the food. Likewise, Prof. A. C. Ivy wrote us that
WILDER TS, STOKES J. ESOPHAGEAL FISTULA IN THE EXPERIMENTAL ANIMAL. Arch Surg. 1931;23(1):111–118. doi:10.1001/archsurg.1931.01160070114007
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