REMOVAL OF CALCIUM FROM THE TISSUES 317 



rate experiments upon a patient with an iliac fistula showed that the 

 cathartic and the bismuth oxychloride travelled down the intestine 

 together, i. e., the cathartic did not reach any point of the intestine in 

 appreciable advance of the shadow cast upon the plate. 



Three persons received two ounces each of bismuth oxychloride i n 

 half a pint of cold water at 8 A.M. Breakfast was given at 8.30. Cecal 

 sounds were heard and a shadow appeared in the cecum four hours 

 after the meal. 



Two days later the same persons received a Seidlitz powder with 

 the same mixture. The shadow appeared in the cecum at the usual 

 time, namely, four hours after the meal, but while normal feces were 

 passed before breakfast, fluid stools, due to the cathartic, were passed 

 at 9.15, 9.40 and 9.45 respectively, no less than three hours before the 

 first trace of bismuth or of the saline cathartic reached the cecum by 

 the way of direct passage through the intestine. 



The same conclusion was reached by chemical analysis of the feces, 

 a sulphate being in this instance employed as the cathartic salt: 



Per cent. Per cent. 



Feces. of water. Total SO4 of SO4. 



First day normal 80.9 0.037 0.045 



Second day normal (10.15) . . . 80.0 0.016 0.032 



Second day watery (11.25) . . . 91.1 0.091 0.041 



Third day normal 77.3 0.270 0.220 



Thus the watery feces evacuated in response to the cathartic con- 

 tained very little more sulphate than the normal feces of the pre- 

 ceding day, while the normal feces of the day following the purgation 

 contained less than the normal percentage of water, and a great excess 

 of sulphates. Were either Liebig's or Wagner and Schmiedeberg's 

 hypothesis the correct interpretation of the facts, we would expect 

 these feces to be very fluid, whereas the experiment shows that the 

 sulphate that remains unabsorbed is actually much less efficient in 

 promoting peristalsis than the proportion which circulates in the blood- 

 stream. That an excess of sulphates were actually circulating in the 

 blood-stream while purgation was taking place is evidenced by the 

 fact that the urine collected between 8 A.M. and 4 P.M. on the second 

 day contained 0.624 grammes more S0 4 than the urine collected during 

 the same period on the previous day. 



It must be admitted that the purgative action of the saline cathar- 

 tics is not to be entirely accounted for by the precipitation of the 

 calcium in the tissues, since Barium and Magnesium, irrespective of 

 whether they are combined with calcium precipitating acids or not, 

 will induce purgation. The possibility must be borne in mind, how- 

 ever, although we as yet possess no direct evidence which bears upon 

 it, that barium and magnesium, being related divalent metals, may 

 possibly displace calcium from certain compounds in the protoplasm 

 of the tisues affected, and in this connection it is perhaps significant 

 that the urinary output of calcium runs parallel to the output of 



