316 INANITION AND MALNUTRITION 



nates at this level, causing dissociation and atrophy of the glandular cul-de-sacs. 

 Sometimes the remnants of the cul-de-sacs are surrounded by abundant 

 lymphoid tissue. 



Aschoff ('13, '21) stated: "Die Atrophie der Darmschleimhaut hat friiher, 

 besonders in der Padiatrie, eine grosse Rolle gespielt. Seitdem Heubner 

 nachgewiesen, dass es sich dabei um einfache postmortale Dehnungsvorgiinge 

 handelt, ist die Atrophie in den Hintergrund getreten." 



Mattei ('14) found the intestinal epithelium normal in 14 cases of athrepsia. 

 Leukocytic infiltration occurred in the villi and interglandular spaces of the 

 mucosa and submucosa. The solitary follicles of the small intestine sometimes 

 showed signs of hyperactivity. The literature on the intestinal changes was 

 fully reviewed by Nobecourt ('16). In general, he concluded that the changes 

 appear to be consequent upon chronic inflammatory processes, especially in 

 the small intestine and colon. 



Finkelstein and Meyer ('22) state: "Formerly it was believed that inanition 

 was the cause of severe 'atrophy' and was due to interference with food absorp- 

 tion in consequence of a chronic inflammation and destruction of the secretory 

 mechanism. The foundations of this teaching are today, however, overthrown; 

 for the concurrent reports of all observers show that the intestine of the atrophic 

 child is anatomically normal. It is clearly a question of functional disturbances, 

 leading to a reversive metabolism, recognized by Parrot many decades ago." 



In famine-stricken children of various ages, Nicolaeff ('23) found the small 

 intestines increased in length (due to meteorism?), with hyperemia, atrophy of 

 the mucosa, and edema of the submucosa. The large intestine showed colitis, 

 with frequent necrotic erosions. There was complete disappearance of mesen- 

 teric and subperitoneal fat, with large amount of peritoneal fluid in some cases. 



The weights of the empty intestines in atrophic Minnesota infants appear 

 relatively large, as shown in Table 3, but the increase is uncertain on account 

 of no adequate norm for comparison. 



In animals, the effects of experimental inanition upon the intestine have 

 frequently been observed. The general results of the more severe stages of 

 inanition will be presented first, followed by a summary of the changes observed 

 during the earlier periods following digestion and absorption. Finally a few 

 observations during hibernation will be mentioned. 



Tiedemann ('36) noted that in starved animals the entire intestinal canal is 

 contracted and contains only a slight amount of bile and mucus. Chossat 

 ('43) observed in starved pigeons a shortening of the intestine with loss of 42 

 per cent in weight, nearly proportional to the loss in body weight. Manassein 

 ('66, '68, '69) observed that the intestines, especially the small intestine, become 

 considerably shortened in rabbits and pigeons during starvation. He observed 

 an average loss of 28 per cent in the intestinal weight of 47 adult rabbits (body 

 weight loss 39 per cent), but usually less in younger rabbits. Upon refeeding, 

 nearly normal length and weight of the intestine were restored. 



Voit ('66) noted an apparent loss of 18 per cent in the empty intestines of a 

 starved cat, with loss of 33 per cent in body weight. Bourgeois ('70) found a 

 reduction of about one-fourth in length and also a decreased diameter in the 



