42 THE ACTION OF THE LIVING CELL 



what has been said, it should be apparent to the reader 

 that since, following inhalation, the anesthetics actu- 

 ally reach the stomach and elicit therein effects analo- 

 gous to those produced by other gastric irritants, we 

 may well expect shock to result from the action of 

 ether and chloroform on the stomach mucosa. This 

 is in agreement with the observations of Brunton 

 (1895), who found that the ingestion of chloroform 

 produced vomiting and irritation of the gastrointes- 

 tinal tract, leading to circulatory depression similar 

 to that observed in shock. 



For many years, clinical observers have noticed that 

 following anesthesia there may be a marked atony 

 of the stomach and intestines. In animals after liga- 

 tion of the pylorus and cardia the writer has observed 

 through a fistula that such atony results in an accumu- 

 lation of gases which distend the stomach. When the 

 gases are removed, gas formation is found to continue 

 at a rate more rapid than could be accounted for by 

 fermentation. The gas, therefore, must have resulted 

 from diffusion of the blood gases. As a result of the 

 distention of the organ by these gases, the splanchnic 

 circulation must be affected in much the same manner 

 as was found to be the case when the stomach was in- 

 flated with air. 



That toxins are actually produced in the stomach 

 as a consequence of atony was easily demonstrated by 

 the injection of filtered stomach contents into normal 

 animals. When stomach contents withdrawn from 

 normal animals was injected into dogs, quantities as 

 great as 40 cc. did not produce toxic effects, whereas 

 smaller quantities of such material taken from patients 

 with atony of the stomach — particularly that result- 



