628 THOMAS E. BROWN AND JOHN H. KING 



occlusions and complete paralysis of the bowel, introduce added factors, 

 in that besides delay in excretion of the feces there may take place a con- 

 siderable degree of decomposition and increased absorption. These fac- 

 tors will be considered when the diseases with which they are associated 

 are taken up. 



The absorptive function of the intestines is protected from marked 

 disturbances by the fact that it is spread over such a wide area in the in- 

 testines. For absorption to be much affected in disease of the intestines, 

 the lesion must be very widespread, especially in the small intestine. It 

 is stated that one-third of the small intestine can be removed without 

 harm, provided the diet is carefully regulated. Hypermotility disturbs 

 absorption much more seriously than does disease affecting the intestinal 

 mucosa, unless that disease be very extensive. 



The intestines differ from any other organ of the body, in that de- 

 composition takes place normally within its lumen. The intestinal chyme 

 is easily subject to decomposition as is evidenced by the fermentation 

 of carbohydrates, conversion of fats into lower fatty acids and the putre- 

 faction of proteins. This normal amount of decomposition has no deleteri- 

 ous effect upon the body, because the products are in the main non-toxic, the 

 amounts elaborated are not excessive and the motility of the intestines in- 

 sures their expulsion from the body without undue absorption. Decom- 

 position as a normal process in the intestines is largely limited to the large 

 bowel and putrefaction is said never to take place above the ileo-cecal 

 valve, except under pathological conditions. However, in disease, the 

 occurrence of excessive putrefaction is followed by deleterious effects on 

 the metabolism of the body and its discussion will be taken up when this 

 phase of the subject is considered. 



It can be therefore seen that as far as the intestines have an influence 

 on the body metabolism their role is a complex one, more involved in the 

 consideration of what particular disturbed function is responsible for 

 the derangement than the type of disturbance caused. For the intestine 

 is in a certain sense the chemical and biological laboratory of the body and 

 its function is primarily to maintain the proper nutrition for the body. 

 So when it is diseased, although the disease processes may vary markedly 

 in their nature and cause, they have one thing in common that they dis- 

 turb the nutrition of the body, no matter what other effects they may set up. 

 For, although there are many diverse processes taking place in the in- 

 testines, their purpose is in the end to prepare the foodstuffs for absorp- 

 tion and to eliminate the unnecessary components of these foodstuffs 

 as well as the waste material from the body. 



So in enumerating the disturbances of metabolism associated with the 

 diseases of the intestines, it will be found that disturbance in the nutrition 

 of the body is the chief complication. Its repeated occurrence borders on 

 the verge of monotony, were it not that, in many of the diseases, it is 



