The development of gastric surgery is one of the most fascinating chapters in surgical history. The first operations on the stomach were done during the second half of the nineteenth century; at first they were minor procedures but then gradually became more daring, major procedures-albeit with considerable mortality. The work of Theodor Billroth and his pupils ushered in the era of major resectional therapy, first for cancer and later also for ulcer disease. Complications due to the lack of understanding gastric physiology plagued the early days of ulcer surgery, and a variety of modifications tried to remedy these problems. Although the role of the vagus was known through Pavlov's studies, its practical application had to wait until well into the twentieth century. For several decades, resection and vagotomy, separately or combined, were practiced until more sophisticated types of vagotomy began to dominate and replace resection in the surgical treatment of ulcer disease. Resection remained the treatment for cancer. We thus see over a period of 100 years, owing to the increased understanding of physiologic factors, a gradual shift from major resections toward smaller, better directed procedures. The pioneering work of Billroth and his generation, however, must not be forgotten.

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The collateral circulation of the lung, i.e., that part of the bronchial flow which drains into the pulmonary veins, was studied by a heart-lung arrangement in which the lesser and systemic circuits of dogs could be perfused separately. In this preparation the collateral supply amounted to 0.5 to 1 per cent of the total arterial flow under approximately normal conditions. The changes in this collateral flow under a variety of experimental conditions were studied. These included variable systemic, venous and pulmonary pressures, lung collapse, air embolism, and actions of CO2 and serotonin.