Diseases of the intestines, their special pathology, diagnosis, and treatment : with sections on anatomy and physiology, microscopic and chemic examination of the intestinal contents, secretions, feces and urine intestinal bacteria and parasites; surgery of the intestines; dietetics, diseases of the rectum, etc / by John C. Hemmeter.

  • Hemmeter, John C. (John Conrad), 1863-1931
Date:
1902
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Licence: In copyright

Credit: Diseases of the intestines, their special pathology, diagnosis, and treatment : with sections on anatomy and physiology, microscopic and chemic examination of the intestinal contents, secretions, feces and urine intestinal bacteria and parasites; surgery of the intestines; dietetics, diseases of the rectum, etc / by John C. Hemmeter. Source: Wellcome Collection.

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    NO PUTREFACTION IN ILEUM NORMALLY. It has been repeatedly emphasized that under normal conditions the rapid passage of the chyme in the small intestine prevents the begin- ning of decomposition in the same, and that putrefaction there 01 e usually begins in the large intestine, the contents of which as a result of much slower peristalsis, move more slowly and often stagnate completely. Since the rapid passage of the chyme in the small intestine is the main reason why the chyme does not decom- pose, it is intelligible that, if the chyme is considerably retarded, as a result of muscular paresis of the small intestine, its contents may become decomposed. After the occlusion of the ileum, when a com- plete stoppage in the passing of the chyme sets in, the conditions in this state are still more favorable for the beginning and increase of the decomposition, and consequently also for the transformation of the chyme into feces, than in the large intestine ; because the contents of the small intestine are liquid or pulpy and rich in albu- minates, which decompose much more easily and quickly than the other food elements, and the decomposition products of which give to the feces their characteristic odor. The important fact, demon- strated by Jaffe, in his experiments on animals, and confirmed by observations made during disease, that in occlusion of the ileum the urine contains more indican (indoxyl-sulphuric acid), which comes from the indol arising from the decomposition of the albuminates in the large intestine, while in occlusion of the large intestine this amount is not increased, is a positive proof for the correctness of the pie- viously mentioned opinion, aside from its great impoitance for the differential diagnosis of occlusions of the large and the small intestine. Under normal circumstances the indol, the parent sub- stance of indican as it occurs in the urine, is formed only in the large intestine and by the decomposition of albuminates. The chyme which passes out of the small intestine into the colon at a normal rate of intestinal peristalsis contains but little albumin, and the amount of indol formed in the large intestine of healthy persons (and consequently also the amount of indican in the urine) is slight. Since after the beginning of an uncomplicated occlusion of the colon (as, for instance, the result of a simple fecal obturation) the de- composition of the albuminates in the large intestine, and conse- quently also the formation of indol in the same, suffers no change, the amount of indican in the urine of the patients remains the same.