AND ABSORPTION 51 



a reverse direction, is pathological, occurring in 

 intestinal obstruction and rare hysterical conditions. 

 In the colon antiperistalsis is the rule. The con- 

 tents of the caecum and the ascending colon are 

 continually seething up and down. The descending 

 colon is normally empty. The pelvic colon is a store 

 for faeces. Once or twice daily the contents of the 

 ascending and transverse colons are suddenly carried 

 over into the pelvic colon and rectum. 



The existence of [these currents of antiperistalsis 

 is very important surgically. Many patients on 

 whom ileosigmoidostomy (turning the ileum into 

 the pelvic colon or sigmoid) has been performed for 

 growth of the ascending colon have suffered great 

 subsequent discomfort from the passage of gas and 

 faeces into the blind loop of colon, from the opening 

 into the sigmoid up into the descending colon, and 

 so round towards the caecum. In some cases a 

 second operation has been necessary. In all ana- 

 stomoses and excisions of the large intestine this 

 physiological factor must be calculated upon and 

 provided for. In some cases an appendicostomy has 

 been performed to allow flatus to escape and to make 

 lavage possible. 



Before turning from the motor functions of the 

 intestines, another experimental observation merits 

 attention. Pawlow found that strong stimulation of 

 any sensory nerves might cause, in dogs, prolonged 

 reflex arrest of peristalsis. Injury of abdominal 

 viscera was particularly likely to do so. Cannon and 

 Murphy have shown that even gentle manipulation 

 of the bowel causes cessation of all intestinal 



