636 AFFECTIONS OF THE INTESTINAL CANAL. 



ADDITIONS TO THE REVISED EDITION OF 1880. 



SECTION V. AFFECTIONS OF THE INTESTINAL CANAL. 



1. P. 590. 



Normal faeces consist of remains of food which are really indi- 

 gestible, and of other parts which were digestible, but from the ex- 

 cessive amount consumed escaped digestion. We find remnants of 

 vegetables, cellulose, starch-granules, muscular fibres, elastic fila- 

 ments, connective tissue, casein, albumen, fat, needles of fatty acids, 

 cholesterin crystals, etc. There are also products from the intes- 

 tinal mucous membrane, cylindrical epithelium, mucus, and diges- 

 tive fluids ; these latter are mostly reabsorbed. The yellow color 

 is due to the changed bile ; the fecal odor to fluid fatty acids com- 

 bined with the products of pancreatic digestion, the acid reaction 

 to fermentation of vegetable matters in the large intestine. 



Although the large intestine has some digestive power and forms 

 peptones and sugar, its chief force is reabsorption ; hence its con- 

 tents become more consistent. Hence if the faeces remain longer 

 than the ordinary twelve or twenty-four hours there, they contain 

 less than their customary seventy-five per cent, of water, and crys- 

 tals of ammonio-magnesian phosphate may give an alkaline instead 

 of the normal acid reaction. 



When there is intestinal contraction and faeces collect above it, 

 the patient is troubled with fulness, pressure and pain in the bow- 

 els, loss of appetite, eructation, flatulence, etc. ; if he now resorts to 

 his customary purgative, or the irritation induces intestinal catarrh, 

 the accumulation is driven through the contraction, and a period of 

 comfort follows, which may last a long time if the patient keeps on 

 an easily-digested diet. 



2. P. 597. 



An attempt may be made to restore a passage through the bow- 

 els by active purges, in most cases of intestinal obstruction, unless 

 we feel sure there is invagination or peritonitis, in which case re- 

 sort is had to opiates, leeches, cold compresses, etc. In the treat- 

 ment of ileus, besides giving purgatives, we should fill the bowel 

 below the occlusion with warm water or air by injections through 

 the rectum ; this sometimes restores permeability at once. These 

 injections of water pass through the large intestine and sometimes 

 enter the small ; they may be made by placing the patient in the 

 knee-elbow position and using a Davidson's syringe, or through a 



