244 



Scientific Proceedings (121). 



its removal are already rather widely known. Suffice it here to 

 say, that as a result of the application of the usual surgical prin- 

 ciples of detoxication by elimination of all foci within reach, the 

 hospital discharge rate has risen from thirty-five to seventy-six 

 per cent. 1 



Over ninety per cent, of all patients classified as "functional" 

 psychotics have marked oral infection. Twenty per cent, present 

 marked evidence of gastro-intestinal disease. Until some better 

 form of therapeusis or early prevention can be found, there seems 

 no better method at hand, as stated by Dr. James Ewing, than 

 surgical removal. Continuing in a report of sixteen specimens of 

 colon and ileum from this series, Dr. Ewing says: 



"The most marked and constant lesion is pigmentation of the 

 mucosa which has rendered the inner lining brownish or at times 

 dark chocolate in color. This change is most marked in the cecum, 

 diminishing toward sigmoid, but often present throughout the 

 specimen. Sections show the pigment to be lodged in large 

 polyhedral cells lying in the mucosa and at times in the epithelium. 

 Pigmentation of the colon is fully recognized as a sign of chronic 

 intestinal stasis and intoxication. It is sometimes associated with 

 anemia and at times with severe and even fatal dystrophies of 

 nervous and muscular systems." 



"Pouching of the intestinal wall amounting almost to hernial 

 protrusions was observed in most of the cases. These pouches 

 were from one to two cm. in depth. The wall of the pouches was 

 generally thinned, sometimes very much thinned, and the mu- 

 cosa at the bottom was generally eroded, sometimes ulcerated. 

 Through such erosions and ulcerations it is obvious that absorption 

 of fluids and bacteria readily occurred." 



"In general, the impression gained from the study of these 

 specimens was that the clinicians were dealing with extensive 

 and somewhat unusual grades of chronic intestinal stasis and 

 catarrhal inflammation with its sequels." 



In 1919, thirty-four partial resections of the colon were made 

 with thirteen deaths or 40 per cent, mortality. In 1920, fifty-nine 

 partial resections were done with eighteen deaths or 30 per cent, 

 mortality. In 1 921, forty-six partial and thirty-one total re- 



1 Cotton, H. A., "The Defective Delinquent and Insane," 1921. 



