METABOLISM IN THE STOMACH AND INTESTINES 639 



these organs have a specific metabolic function, as the pancreas, the 

 liver or the ductless glands, then the metabolic effects resulting from dis- 

 turbances in their functions will be added to the cachexia. 



Sarcoma and Lymphosarcoma of the Intestines. These tumors are 

 less frequent than carcinoma but often grow more rapidly. They lead 

 less often to obstruction, except when situated in the rectum. Their effects 

 on the body metabolism are in general similar to those of carcinoma. 



The Specific Diseases of the Intestines 



Tuberculosis of the Intestines. The metabolic feature of this disease 

 are in general those associated with tuberculosis. The disease may be 

 rarely primary in the intestines and regarded as simple chronic catarrh. 

 Often it is only when emaciation supervenes, or spontaneous hemorrhage 

 from the bowel occurs, or signs of pulmonary tuberculosis become ap- 

 parent, that the true nature of the disease is suspected. When the disease 

 involves the cecum, a considerable narrowing of the intestinal lumen may 

 occur, adding the feature of intestinal stasis to those of tuberculosis itself. 

 The general metabolic effect is emaciation, to which the intestines may 

 add that of intestinal stasis with toxemia. 



Syphilis of the Intestines. This disease affects mainly the rectum, 

 where it produces a slow growing stricture with symptoms of obstruction 

 of the lower bowel. Rarely there occurs an enterocolitia of specific origin 

 associated with ulcers, diarrhea arid wasting. The metabolic complica- 

 tions are those caused by the syphilitic process itself, which may have 

 affected many of the organs of the body. The disturbances, which the in- 

 testinal components of the disease cause, are those associated with intestinal 

 stasis. 



Intestinal Disturbances Secondary to Diseases of the Stomach. 

 There is a very striking clinical condition, characterized by profuse and 

 frequent watery discharges from the intestines, associated with complete 

 absence of hydrochloric acid in the stomach. The symptoms are largely 

 intestinal, and the fecal movements may contain whole particles of undi- 

 gested food matter. The movements may be as many as ten to twenty 

 a day. If the disease has existed for any considerable length of time, 

 marked loss of weight and strength result, the patients presenting a clin- 

 ical picture suggesting malignancy of the intestines. There is marked 

 hypermotility of the intestines, so much so that there is little time for 

 digestion by the intestinal ferments, or absorption by the intestinal mucous 

 membrane to take place. In what way the absence of hydrochloric acid 

 produces this condition is not known. It is not through influence upon 

 the bile or pancreatic ferments, for they are normal in this condition. 



