HOW AUTO-INFECTION AFFECTS INTESTINAL DIGESTION, AND VICE VERSA.
Intestinal indigestion is a more common form of functional disturbance
than is gastric indigestion. It is a well established fact that the
greater portion of the digestive work is done beyond the stomach, in
the duodenum, by the hepatic and pancreatic fluids. The duodenum--very
properly called the _second stomach_--has none of the peculiar
characteristics of a receptacle that receives crude substances--the
office of the stomach. Much greater sensitiveness characterizes the
digestive canal than the stomach; which is accounted for by the fact
that a network of nerves, forming the sympathetic system, surrounds the
bowels. The symptoms of intestinal indigestion are not always clearly
defined and distinguishable from gastric indigestion, especially as the
two are frequently associated.
The cecum, more than any other portion of the digestive canal,
resembles the stomach, and it secretes an acid, albuminous fluid having
considerable solvent properties. It is to be observed that as the cecum
is only three inches in length and two and a half in diameter, and as
its contents are necessarily propelled in opposition to gravity, a
slight casualty will hinder or obstruct the upward movement of the
pultaceous mass of the effete ingesta. The turning point in the
ascending colon affords another ready hindrance to the upward and
onward movement of this mass; and the gases and ancient feces beyond
the turn conduce to further sluggish peristalsis, bringing about more
or less obstruction and reflex irritation of the remaining length of
intestinal canal. Undue retention of the contents of the cecum, and the
disturbance and obstruction of the duodenum by the pressure incident to
the distention of the colon with feces and gases, lead to congestion,
inflammation and occasionally to ulceration of the mucous membrane in
various parts of the intestinal tube.
This condition of affairs increases the occlusion (closing) of the
bowels, but makes very easy indeed the entrance and propagation of
micro-organisms in the sub-mucous coat of the intestine. The conditions
are now ripe and rife for auto-infection. Which of the following
microbes are the most active agents of progressive auto-infection: the
streptococcus lanceolatus, the bacterium pyogenes, the bacillus
subtilis, the staphylococci, the bacterium coli commune? They all play
a part in the game, reducing the body in time to a charnel-house. Or
are such substances as putrescein, cadaverin, skatol or indol--which
are derived through chemical change in the putrescent mass--contributors
to the spread of the poisonous taint throughout the system? Any single
one or a group of the fifty or more bacterial poisons may be the
responsible agents in the ensuing auto-infection. Chemical analysis of
the gases resulting from decomposition reveals oxygen, nitrogen,
hydrogen, carbonic acid, protocarbonated hydrogen and sulphureted
hydrogen, ammonia, and sulphate of ammonia. Leucin, tyrosin, lithic
acid, lithates, xanthin, cystin, keratin, sulphureted hydrogen, etc.,
are deposits in the urine and are signs of the derangement of the
intestinal canal and liver. The external symptoms observed are the
following: the tongue is large, pale, flabby and indented by the teeth
at the edge of the anterior third, while its surface is white and the
papillæ often enlarged; the appetite may be excellent, though there is
great functional derangement of the liver with lithemia, so that the
sufferer is tempted to eat what he knows from experience will disagree
with him; a bitter coppery taste in the mouth, due to taurocholic
acid--a common symptom of lithemia or of imperfect oxidation of
albumen; emaciation, fatigue, depression, headache, buzzing in the ears
and deafness, disturbance of sight, loss of memory, faintness and
vertigo, very marked in some cases; sometimes tenderness and pain under
the cartilages of the right ribs; the fretting of the sensitive surface
of the bowels by imperfectly digested, semi-putrescent food, resulting
sometimes in convulsions, coma, paralysis, or in fetid diarrhea of an
acid character producing a burning sensation or pain of the anus when
the discharges are being passed; rumbling and twisting sensations in
the region of the navel occurring with flatulency, and occasionally
colicky pains which at times are so severe as to simulate poisoning.
In some people certain articles of food, without being either toxic or
putrid, induce indigestion and the production of microbes in quantity
amounting to one third of fecal dejections. Prof. Ch. Bouchard says:
"The consequence of this development of acid in the whole length of
the digestive tube is an inflammatory condition. We notice catarrh
of the stomach, ulcerative gastritis, to which patients often
succumb after twenty-five years of _bad stomach_; these are the
_false cancers_, as they are called, or malignant gastritis
without tumor. The large intestine is inflamed; around the fecal
matter are seen glairy secretions and sometimes blood (membranous
enteritis)." (Op. cit., p. 159.)
In chronic inflammation of the rectum and colon there is more or less
discharge of mucous, and in some cases of membranous, desquamation,
with yellow or bloody mucus. The shreds, cords or complete tubular
casts are discharged constantly or at varying intervals. The quantity
and character often alarm the sufferer. The discharge is nothing less
than a thick, tenacious mucus that had formed a thin coating on the
inflamed mucous membrane, and become exfoliated in casts or thin
shreds--the result of many years of morbid intestinal exaggerated
action.
Microscopical examination of the desquamated intestinal membrane and
mucus from a man forty years of age, revealed the following products:
crystals, mostly complete; incomplete phosphates, very numerous; mucous
shreds in abundance; fat globules and granules, numerous; anal
epithelia; red blood globules, few; connective tissue, scanty; pus
corpuscles, very few; margaric acid and detritus (substances resulting
from the destruction or wearing away of the part); undigested material,
mostly cellulose; leptothrix threads, micrococci; and the bacillus coli
communis. Diagnosis: foul, undigested material, due to a chronic
inflammation of the lower intestinal tract. The microscopical
examination of mucus and desquamated membrane from a woman sixty-five
years of age, disclosed that she was suffering from proctitis and
colitis. She wrote: "Please tell me how long this mucous discharge must
continue. I am alarmed at the quantity of membrane, cords, casts, etc.,
in my excreta, and I think that if this process goes on much longer
there will soon be no bowels left to purify." This letter was written
some weeks after contracting a severe cold, which accounts for the
unusual amount of exfoliation and mucus. The sample she sent contained
a large quantity of mucus, both threads and corpuscles; with a moderate
number of epithelial scales, partly anal and partly intestinal. Pus
corpuscles were present in small numbers; also vegetable fibres, fat,
starch, muscle fibres and cellulose--the remains of undigested
material. In the membranes themselves no micro-organisms were found; in
the pieces containing undigested material the bacillus coli communis
was found as well as micrococci, and the bacilli of putrefaction
(secondary formation) were seen.