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
Catalogue details

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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    COLLAPSE AND WATER IMPOVERISHMENT. the stomach by means of vomiting, whilst the lower parts of the abdomen are retracted. If the intestinal lumen is occluded in the lower section of the ileum, the abdomen may be symmetrically bul-ed out in the umbilical region. If this diffuse symmetrical dis^ tendon is restricted to the umbilical and subumbilical region, there is, as a rule, no distention of the transverse colon. Deductions from the localization of the most pronounced meteorism must be made soon after the initial symptoms to be of any diagnostic value. Appearance of Collapse.—The symptoms of great collapse, appearing soon after an acute intestinal occlusion, are the result of the strong mechanical irritation which acts upon the roots of the splanchnic nerve during the incarceration (strangulation shock). The strong irritation of the splanchnic, which is not only the sen- sory, but also the vasomotor nerve of the intestines (its stimulation causes anemia, its paralysis an advanced state of hyperemia), often leads to its paralysis and consequently to an overfilling of the intes- tines and other hypogastric organs with blood. Since the blood- vessel area of the intestines is the greatest in the entire body, its overfilling with blood causes an anemia of other organs and parts of organs, and this is the cause of the most important symptoms of collapse : fainting spells, roaring noises in the ears, flashes be- fore the eyes,—sometimes coma and delirium occur, which often precede the collapse, and are usually ascribed to anemia of the biain. It is presumed that the tonus of the vagus is decreased in this cerebral anemia, and as the vagus is the inhibitory neive of the heart, the pulse in collapse is therefore more rapid when this nervous control is lost, and veiy soft and of low tension, besides, as a lesult of the incomplete filling of the arterial system. The skin, to which less blood flows than usual, is anemic, cool, especially in the pendent parts of the extremities ; the body temperature is usually subnormal. The decrease in the arterial pressure, making itself felt in the blood-vessels of the kidneys, causes oliguria. Water Impoverishment of the Blood.—It has already been mentioned that many symptoms of occlusion such as the torturing thirst, the dryness of the tongue and mouth, the oliguria and an- uria, the decrease in the amount of blood in the skin, muscular cramps—are to be explained by the great loss of water which the blood sustains as a result of vomiting, sweating, supersecretion of the