AND ABSORPTION 53 



Water is absorbed in the large intestine. 



The practical physician or surgeon is concerned 

 with the physiologist's answer to two questions. 

 First, Is the colon a necessary organ, or may it be 

 eliminated with safety ? Second, Can the large 

 intestine absorb useful food-stuffs in case of need ? 



With regard to the first point, we are at once con- 

 fronted with the fact that in some bats the colon is 

 exceedingly short. Again, it is well known that 

 patients with an artificial anus in the caecum are able 

 to keep up their nutrition. The same is true after 

 the ileum has been cut across and turned into the 

 sigmoid. Careful analyses made by Groves and 

 Walker Hall under these conditions show that the 

 normal amount of water can still be absorbed by the 

 short piece of rectum and sigmoid traversed by the 

 food ; the faeces are not too fluid. By comparing the 

 amount of water in the intestinal contents at the 

 ileo-csecal valve and as passed naturally in man, they 

 conclude that the colon absorbs about 10 to 20 per 

 cent of water from the fasces. Bacteria make up 

 nearly half the weight of the faeces as passed normally. 

 Treves, Lane, and others have excised almost the 

 whole colon without the patient's nutrition suffering. 



We conclude then that the colon is not a necessary 

 organ. If, however, a permanent artificial anus is 

 made in the ileum more than 12 to 18 inches away 

 from the ileo-caecal valve, absorption is inadequate 

 and the patient dies of starvation. 



Turning to the second question, it is scarcely 

 necessary to call attention to its very great 

 importance. If the colon cannot absorb a reasonable 



