METABOLISM IN THE STOMACH AND INTESTINES 637 



the outlines of the giant colon are plainly visible to the naked eye. On 

 the other hand, it is surprising how long and how great an amount of fecal 

 matter can be retained in these colons without producing any outward 

 symptoms of disturbing the nutrition of the body. 



The Nervous Enteropathies 



(a) Disturbances of Motor Innervation of the Intestines. 



(1) Peristaltic Unrest. 



(2) Hypermotility of the Intestines. 



(3) Paralysis of the Intestines. 



(4) Paralysis of the Sphincter Ani Muscle. 



(b) Disturbances of Sensibility of the Intestines. 



(1) Hyperesthesia of the Intestines. 



(2) Neuralgias of the Intestines. 



(c) Disturbances of Secretory Innervation of the Intestines. 



(1) Mucous Colitis. ' 



In this group metabolic complications are associated practically with only 

 two of the subdivisions. 



Hypermotility of the intestines may lead to a nervous diarrhea or 

 to spastic constipation. Rarely are the effects sufficiently great or of such 

 long duration as to cause much interference with nutrition. In the 

 diarrheas associated with hyperactivity of the thyroid gland, and the con- 

 dition of achylia gastrica, there may be serious interference with the 

 proper nutrition of the body and very marked loss of weight and strength. 

 These diarrheas are associated with hypermotility of the intestines, but 

 will be discussed separately under their proper headings. 



Mucous colitis is regarded by many authorities as a pure neurosis. 

 A neuropathic tendency is considered to be an essential precursor of this 

 disease. The actual acute attacks, in which there are painful spasms in 

 the colon followed by the passage of mucus in the feces, are probably 

 initiated by reflex causes, as chronic appendicitis, cholecystitis, gastric or 

 duodenal ulcer, or the accumulation of fecal matter in a posted colon. 

 Generally the sufferers from this disease are undernourished, pale and 

 often present the visceroptotic habitus. When the disease is of long stand- 

 ing, marked grades of malnutrition may ensue, bordering on emaciation. 

 The victims of this malady often diet themselves very rigidly, or are unable 

 to take much nutriment, so that they are at times existing on a practically 

 starvation diet. There is no specific effect on the metabolism in this dis- 

 ease. The malnutrition results from interference with the proper intake, 

 digestion and absorption of the foodstuffs and not from any peculiarity 

 of the disease itself. 



