RESULTS OF (!.l,STh'<>-l\Ti:sT/\\l. I \T()\ l<!.\TI()S 587 



ism, clilorosis aiul pernicious auciiiia, cirrhosis, ii('])lii-itis, and arterio- 

 sclerosis.'" Wliile in many cases the severity of tliese various eou- 

 ditioiis is apparently augmented by intestinal disturbances, the etio- 

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

 testinal 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 ^letchnikoft' and his associates, who have produced ar- 

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

 is well known, ^letchuikoft* 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 potency which, presumably, might 

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

 a certain type of cases of defective development led Herter '•* to the 

 conclusion that intestinal intoxication is responsible, and hence he 

 designated this condition "intestinal infantilism." 



Tetany associated with gastric dilatation offers perhaps the strongest 

 case, numerous observers having reported finding a marked toxicity 

 of the stomach contents.'^^ Pineles ^^ considers that all forms of tet- 

 any, whether of gastric origin or following thyroidectomy, are due 

 to one and the same "tetany poison." 



Although there are usually evidences of intoxication in acute dila- 

 tation of the stomach, yet there is no good evidence as to its nature. 

 It is suggested by Woodyatt and Graham "^ that the dilatation is pro- 

 duced by CO, secreted into the stomach from its walls. There is also 

 considerable evidence that the tetany, when present, is associated 

 with a deficiency in calcium in the blood and nervous tissue, and 

 that this is further related to the functional activity of the parathy- 

 roids {q. I'.). 



The relation of intestinal intoxication to the various anemias, par- 

 ticularly chlorosis and pernicious anemia, has been repeatedly indi- 

 cated and discussed. Clinical evidence strongly indicates that such a 

 relation exists, and there is no doubt that hemolytic substances may 

 be formed in the alimentary tract, ^° but that chlorosis and pernicious 



T3 The relation of orastro-intestinal intoxicatinn to these various diseases is re- 

 viewed by Weintraud, Ergeh. alio:. Pathol., IS!)? (4), 17. 



74 See Ann. Inst. Pasteur, 1010 (24). 75.i. 



75 See Granger, Arch. Int. :\red., 1!)12 (10). 202. 



Tfi See McCnidden, .Jour. Exper. INled., 1012 (If)), 107. 



"Bibliography bv Halliburton and McKendrick. P.rit. M.d. -Tour., inoi (i), 

 1G07. 



78Deut. Arch. klin. Med., 1006 (S.5). 401. 



79 Trans. Chicago Path. Soc. 1912 (8), 3.")4. 



80 See Kiilbs, Arch, exper. Path.. 1006 (o.5), 7.3: also Herter, .Tour. P.iol. Cheni.. 

 1906 (2), 1. 



