Flatulence and shock / by F.G. Crookshank.

  • Crookshank, F. G. (Francis Graham), 1873-1933.
Date:
1913
Catalogue details

Licence: Public Domain Mark

Credit: Flatulence and shock / by F.G. Crookshank. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    8/54 (page 8)
    and so others take refuge in saying that the gas is really swallowed air, though surgeons who have experience of ileus Imow full well that this will not do. They, as a rule, frankly admit that there is at work some influence that has not yet been precised. Physicians are somewhat less candid. In cases of chronic gastric dilatation without organic ob- struction at the pylorus, there is, of course, a definite forma- tion of lactic and butyric acids, with evolution of carbonic acid and hydrogen. It is accepted that these processes are the result of microbic fermentation, and also that, when yeast is present, the alcoholic and acetic fermentations may proceed with like evolution of gas. It is also seemingly true that, when certain articles of food have been ingested, sulphuretted hydrogen is produced in the bowels, or more rarely in the stomach ; and that when leguminous foods containing much cellulose have been eaten, marsh gas and hydrogen are evolved on a quite extensive scale. As you know, those who concern themselves with the dis- orders of children have lately been at pains to distinguish between the putrefactive and the fermentative organisms, associating the former with decomposition of proteid food* and the latter with that of carbohydrates ; recognizing, more- over, the putrefactive process as inhibitory of the fermenta- tive. So that one has to be a little careful in the use of words. But, speaking broadly, we admit a group of cases in which there is production of gas in the stomach and bowels as a result of disintegrative processes due to microbic activity. Sometimes there is gross error in diet; sometimes there is special importation of special organisms ; but in any case an atonic condition of the digestive organs is present, and con- siderable delay in the passage of food from the stomach, so that the organ becomes dilated. There is a vicious circle ; atony and deficient juices favour fermentation ; gas produc- tion distends the stomach and sets up dilatation. And the gas that is eructated is. as the patient will say, neither odour- less nor flavourless. It may even be inflammable. But there are the cases, not so easily disposed of, where neither yeast nor the Bacillus butyricus occurs in the stomach contents, and, rather curiously, even lactic acid is not always present. Such cases fall into two groups : one called neu- rotic, with which I am most concerned ; and another, that