vi INTESTINE AS AN OKG-AN OF EXCEETION 363 



symptoms during the anuria is more particularly due to the 

 vicarious action of the entire intestinal tract. Although 

 direct evidence for this is wanting (since the faeces were not 

 examined chemically for urinous products) it seems from the 

 physiological point of view to be incontestable. Eossoni, to 

 account for the absence of acute uraemic phenomena during the 

 anuria without vomiting, invokes the extreme slowness of meta- 

 bolism in the two hysterical patients. There is not, however, the 

 slightest proof of this, and even if it were proved, it would at 

 most explain the oliguria and not the prolonged periods of total 

 anuria. 



Kossoni's statement, that injections of pilocarpine were always 

 able in the first subject to interrupt the anuria by reactivating 

 the renal function and improving the general state of the patient, 

 while in the second they only promoted the vicarious functions 

 of the skin and salivary glands, is interesting. But according to 

 what we stated in Chapter IV., the pilocarpine, both in the first 

 and the second subject, must have activated the secretion of all the 

 glands connected with the gastro-intestinal canal, particularly the 

 liver and the crypts of Lieberklihn, from which it is probable that 

 the most highly toxic products poured out into the blood from the 

 tissues were eliminated by the intestine, during the total suspen- 

 sion of renal secretion. 



Since the innocuous character of injections of urea, when the 

 kidneys are functioning normally, is well known (Chapter VII., 

 pp. 411, 413), the fact which Kossoni observed is very interesting, 

 i.e. that the administration of 12 grms. urea during anuria caused 

 a uraemic attack, due no doubt to a sudden rise in the osmotic 

 pressure of the blood. In the second hysterical patient, hypo- 

 dermic injection of 15 grms. urea during the anuria without 

 vomiting produced the same effect, while a second dose of 14 

 grms. urea was tolerated without toxic symptoms, because it was 

 given during the anuria accompanied by abundant urinous vomit- 

 ing, i.e. when the patient was urinating not by the kidneys, but 

 by the stomach. 



VI. The complex task of the intestinal apparatus, as expressed 

 in the triple function of digestion, absorption, and excretion or 

 formation of faeces, ends with the mechanical process of defaeca- 

 tion. It is generally assumed for man that the intestinal chyme 

 remains in the majority of cases for about 4 hours in the small 

 intestine, and about 22 hours in the large bowel (Nothnagel). 

 The peristaltic movements which drive it onwards become pro- 

 gressively slower in proportion as it descends into the lower parts 

 of the small intestine. Along with this delay there is a constantly 

 increasing condensation of the intestinal contents, in consequence 

 of the absorption of water, and of the absorbable constituents of 

 the chyme. In proportion as the contents of the intestine assume 



