342 INFECTIONS OF THE DIGESTIVE TRACT 



this end in view have in a number of instances been 

 practiced, but not, so far as I am aware, with the primary 

 object of greatly reducing the opportunities for intestinal 

 putrefaction. The value of such procedures is therefore 

 as yet largely a matter of conjecture. That the elimina- 

 tion of the large intestine would be followed by a very 

 great reduction in the absorption and excretion of pro- 

 ducts of decomposition must be regarded as certain. 

 The experiments which have been made by Baumann 

 and others on dogs in which a fistula in the ileum had 

 been established, leave no room for doubt that putre- 

 faction is greatly decreased by such a procedure. 1 The 

 closure of the fistula and the reestablishment of the 

 natural paths have been in such cases promptly followed 

 by a renewed excretion of the ethereal sulphates. Aside 

 from the surgical difficulties incidental to operations 

 designed to shorten the large intestine there are two 

 possibilities of a disadvantageous outcome which will 

 have to be tested by future experience. One of these 

 is the possible detrimental influence of such a shortening 

 of the gut upon the processes of nutrition. It is claimed 

 by some physiologists that the processes of peptoniza- 

 tion and absorption continue to be carried on in no 

 unimportant degree in the large intestine, and hence that 

 an elimination of a considerable portion of this part of 



1 In a dog whose ileum was inserted a few inches above the 

 rectum the ethereal sulphates were low but the indican reaction 

 (on a meat diet) was intense. This animal was prepared for use 

 by Dr. Carrel of the Rockefeller Institute. The fluid faeces con- 

 tained indol. After the operation there was a considerable gain in 

 weight on a strict meat diet. 



