594 GASTRO-INTESTINAL "AUTOINTOXICATION" 



toxic substances in the intestinal contents in ileus (experimental), and 

 similar substances could also be obtained by growing cultures of the 

 intestinal contents on bouillon. Another explanation is that many 

 unidentified poisonous substances are produced in the alimentary 

 canal which ordinarily are destroyed, but under certain conditions 

 may be reabsorbed. That unrecognized toxic substances are formed 

 in the intestines is almost certain, for it has been repeatedly shown 

 that extracts of the contents of the alimentary canal are very poison- 

 ous. Although the technic of many of these experiments has been 

 questionable, the results have been obtained so often as to render it 

 probable that the main contention is correct.^ Thus Magnus-Alsle- 

 ben^ has found in the upper part of the small intestine of dogs (ex- 

 cept when on milk diet) a very poisonous substance which killed rab- 

 bits by respiratory paralysis, but which is inert when injected into the 

 portal vein. Extracts of the wall of the large intestine are also toxic, 

 and lose their toxicity at 60°, by passing through porcelain filters and 

 by treatment with alcohol; extracts of fetal intestines are not toxic 

 (Distaso).^ There is reason to believe that histamine is responsible 

 for much of the toxic effects obtained with intestinal materials. 



In any case, correctly or incorrectly, a great number of disease con- 

 ditions have been attributed to poisons of gastro-intestinal origin, 

 including not only such minor conditions as headache, malaise, lassi- 

 tude, etc., but also sciatica, tetany, epilepsy, eclampsia, many forms 

 of dermatitis, various forms of nervous diseases, myxedema and 

 cretinism, chlorosis and pernicious anemia, cirrhosis, nephritis, and 

 arteriosclerosis.^ While in many cases the severity of these various 

 conditions is apparently augmented by intestinal disturbances, the 

 etiologic relation is not so clear. That long-continued intoxication of 

 intestinal origin may cause serious injury to the tissues is, however, 

 extremely probable. There is much reason for believing that many 

 cases of non-alcoholic cirrhosis are due to this cause; not improbably 

 chronic nephritis, myocarditis, and arteriosclerosis may occasionally 

 be the result of long-continued intoxication from the same source. 

 Arteriosclerosis especially has been attributed to indole and related 

 substances by Metchnikoff and his associates, who have produced ar- 

 teriosclerosis in rabbits by injecting indole, but not with skatole. As 

 is well known, Metchnikoff believed that most of the manifestations of 

 senility come from putrefaction in the large bowel, ^° and a number 

 of observers have described as products of intestinal putrefaction cer- 

 tain pressor substances of high potcnc,y which, presumably, might 

 cause serious arterial and cardiac injury. ^^ An elaborate study of 



* For example, see Roger and Gamier, Compt. Rend. Soc. Biol., 1905 (59), 

 388 and 674; 1906 (60), 666. 



' Hofmeister's Beitr., 1905 (6), 503. 



8 Zcit. Immunitat., 1913 (16), 466. 



' The supposed relation of gastro-intestinal intoxication to these various dis- 

 eases is reviewed by Weintraud, Ergeb. allg. Pathol., 1897 (4), 17. 



'« See Ann. Inst." Pasteur, 1910 (24), 755. 



" See Granger, Arch. Int. Med., 1912 (10), 202. 



