Ileum

“ These three sections form the small intestine, which in man is about twenty feet in length, but is subject to great variations. The lumen of the small intestine is larger at its upper end and gradually narrows as it goes downward. The opening of the ileum into the caecum, the first portion of the colon, is valvular, and this arrangement prevents any passage backward of the intestinal contents. ”

“ At the time when the intestine still presents the primitive arrangement of the umbilical loop (Figs. 104 and 130) this vessel passes between the layers of the dorsal mesentery through the narrow duodeno-colic neck to reach the two limbs and the apex of the intestinal loop. In its course it gives off successively branches to the gut from each side. Those from the right side of the main vessel pass to the duodenum, pancreas, jejunum and ileum. ”

“ We have, in succession, the mouth (M.) , separated from the nasal passage (Na.) above the palate; the pharynx (ph.) , where the right and left nasal passages open by the posterior nares into the mouth; the oesophagus (oes.) ; the bag-like stomach, its left (Section 6) end being called the cardiac (cd.st.) , and its right the pyloric end (py.) ; the U-shaped duodenum (ddnm.) and the very long and greatly coiled ileum (il.) . The duodenum and ileum together form the small intestine; and the ileum is dilated at its distal end into a thick-walled sacculus rotundus (s.r.) ”

“ The duodenum is not a U-shaped loop, but makes one together with the stomach; the pancreas lies between it and the stomach, and is more compact than the rabbit's. There is no separate pancreatic duct, but the bile duct runs through the pancreas, and receives a series of ducts from that gland as it does so. The ileum is shorter, there is no sacculus rotundus, and the large intestine has no caecum, none of the characteristic sacculations of the rabbit's colon, and does not loop back to the stomach before the rectum section commences. ”

“ Within this loop is a long pinkish gland, the pancreas, which empties by a duct into the duodenum. Into the duodenum also the overlying liver empties its secretion of bile from the median-placed gall-bladder. From the duodenum the small intestine or ileum extends with many convolutions to its exit through the cloacal aperture. On the intestine near the cloacal opening note a pair of glandular structures, the cæca. The short part of intestine between the cæca and cloaca is called the rectum. On the left side of the body beneath the gizzard note a dark glandular structure, the spleen. ”

“ The small intestine is a tube, from 22 to 25 ft. long, beginning at the pylorus and ending at the ileo-caecal valve; it is divided into duodenum, jejunum and ileum.
The duodenum is from 9 to 11 in. long and forms a horseshoe or C-shaped curve, encircling the head of the pancreas. It differs from the rest of the gut in being retroperitoneal. Its first part is horizontal and lies behind the fundus of the gall-bladder, passing backward and to the right from the pylorus. ”

“ The process of digestion, as the food passes from one end of the tract to the other, is performed by the aid of the secretions of various glands, which open into the alimentary canal at different points in its course. The principal of these are the salivary glands, situated on the pharynx and oesophagus, and the liver, biliary or hepatic gland, connecting with the stomach. With these may be considered the anal and ink-glands, which, in certain genera, connect with the terminal portion of the rectum. ”

“ And it is not at all strange that they should, since there is so much pressure from within, so much pressure downward, and so much pressure from without—all through the requirements of fashion, indulgence, and ignorance. But the stomach, upper portion of the duodenum, and small intestine, cæcum, the ascending colon, and especially the transverse colon and sigmoid flexure, are susceptible to various forms of displacement, inhibiting the ready flow or passage of food stuffs, gases, and feces from one segment of the digestive apparatus to another, until the vent is reached. ”

“ The large intestines are easily cured, but the small ones with difficulty, and the jejunum is utterly incurable, from the multitude of its convolutions and the magnitude of its vessels, and owing to its coats being thin and nervous; besides, it receives all the bile in an undiluted state, and is nearest to the liver. The under and fleshy parts of the stomach we may attempt to cure, for we may succeed, not only because these parts are thicker, but because curative medicines are more readily applied to them, owing to their situation. ”

“ He proved that bile, which used to be considered an excretion, was really an important digestive secretion. He was not able to demonstrate the function of bile as completely as he had done for the gastric juice. The problem of intestinal digestion is much more complicated than that of stomach digestion, and involves a number of factors for which allowance has to be made if the value of any one of them is to be accurately determined. Even in our own day all of the physiological problems in the functions of biliary secretion are not solved. ”

“ So much attention and flirtation does the liver receive from the liver-persuaders that the pancreas ought to be very jealous. The pancreas excretes quite as much fluid into the duodenum as its larger neighbor, and is, therefore, no mean organ. And we need not wonder should we find the intestinal glands piqued at our over-attention to the liver, as they, in their work at the metamorphosis of digested food into blood, excrete two or three gallons of fluid in a day to the liver's two or three pints ”

“ DISEASES OF THE LIVER. Liver complaints are always closely related to other diseases of the digestive organs. The colon being clogged, the intestines are rendered sluggish, which in turn acts upon the duodenum, or second stomach, and prevents the food from properly passing out—then fermentation takes place. Bile is poured out on the accumulated food again and again, for the presence of anything in the duodenum is a demand for the secretion of bile. ”

“ Causes.—The liver does not perform its function well, or there is a retention of bile in the bile ducts. Most of the symptoms do not depend directly upon the changes in the bile, but upon failure of proper digestion in the stomach and intestines. Certain poorly prepared foods or improper food for stomach digestion, quickly cause the development of active fermentation and its results irritate the stomach mucous membrane bringing about a faulty stomach secretion of mucus, which causes further trouble. It may end in a sick headache. ”

“ The chyme not only excites an action in the duodenum, but also in the liver and pancreas. Mucus is then secreted by the duodenum, bile by the liver, and pancreatic fluid by the pancreas. The bile and pancreatic fluid are conveyed into the duodenum, and mixed with the chyme. By the action of these different fluids, the chyme is converted into a fluid of a whitish color, called Chyle, and into residuum.
Observation. The bile has no agency in the change through which the food passes in the stomach. In a healthy condition of this organ, no bile is found in it. ”

“ The stomach, after a variable length of time, during which the peptic ferments accomplish their allotted task more or less thoroughly and completely, delivers the resultant mass over to the small intestine, where the secretions from the pancreas, liver, and intestinal glands, by finishing the transformation of the starch begun before the stomach was reached, emulsifying the fatty constituents, etc., complete the complex work of digestion. ”

“ The course of the food in the small intestine.—Chyme is not forced from the stomach by every wave that passes over the antrum, but only at intervals. When the pylorus relaxes, the food, moved towards the pylorus under considerable pressure, is squirted along the duodenum for two centimetres or more. Careful watching of this food shows that usually it lies for some time in the curve of the duodenum until additions have been made to it from the stomach, and a long, thin string of food is formed. ”

“ Only in our own day has come the greatest confirmation of the notion then first introduced into physiology, of the surpassing importance of intestinal digestion. The removal of the whole stomach for malignant disease is now undertaken without any fears as to the ultimate result on the patient's general nutrition. The operation has been done many times, and the surgeon's confidence that the intestines would compensate, as far as digestion of food was concerned, for the absent stomach has been amply justified. ”

“ The abdomen may be divided into three regions; in the upper region will be seen the liver, extending across from the right to the left side, the stomach and spleen on the left, and the pancreas and duodenum behind; in the middle region is the transverse part of the colon, with the upper part of the ascending and descending colon, omentum, small intestines, mesentery, and behind, the kidneys and supra-renal capsules; in the inferior region is the lower part of the omentum and small intestines, ascending and descending colon, and ureters. ”

“ Rapid Relief From Colon Cleansing
During fasting the liver is hard at work processing toxins released from fat and other body deposits. The liver still dumps its wastes into the intestines through the bile duct. While eating normally, bile, which contains highly toxic substances, is passed through the intestines and is eliminated before too much is reabsorbed. (It is the bile that usually makes the fecal matter so dark in color.) However, reduction of food bulk reduces or completely eliminates peristalsis, thus allowing intestinal contents to sit for extended periods. ”

“ Four or five of these folds enter into the intestine, and here, for about a quarter of an inch, they become but very slightly elevated; as they approach that peculiar semiflexion in the intestine referred to above, they increase in number, and also in depth (Fig. 4) , and, from their very close and compact appearance, I am led to suspect that this portion of the intestine, between the pyloric orifice of the true stomach and the orifice of the biliary ducts, is more than an ordinary duodenum, and acts somewhat as a secondary stomachal cavity. ”

“ In a state of health the abundantly secreted gastric juice speedily redissolves the chief part of the curd in the stomach, while when it has passed into the intestine the alkaline bile which there becomes mixed with it, completes its solution, and converts the whole into a fluid which closely resembles one of the chief elements of the blood, is consequently very easily taken up by the minute vessels whose office it is to do so, and thus supplies with nourishment the whole body. ”

“ They are acted upon by the digestive juices in the stomach and small intestine, and are absorbed into the circulation. The liver, in its capacity of separator, objects to their introduction as harmful to the system and casts out with increased secretion of bile that portion which reaches it. ”

“ The integrity of the functions of the intestines is of supreme importance, for it is here that absorption and assimilation of most 183of our food occurs. If our intestines are not in perfect order we shall soon waste and dwindle away, even within a short period, and sometimes very rapidly. Thus if we wish to retain our strength we must treat the intestine with the greatest care. This is especially the case in old age, for then an atrophy of the glandular mechanism of the digestive tract, stomach, and intestines, takes place. ”