Large intestine

“ An overloaded condition of the large intestine may cause inflammation of the liver or dropsy of the abdomen. When the colon is distended, it becomes a mechanical impediment to the free circulation of the blood in other organs, and causes congestion of the portal system, predisposing to chronic inflammation or cirrhosis of the liver. This latter is a structural affection, and may, in turn, give rise to abdominal dropsy. In a word, the accumulation of feces in the colon irritates both the large and small intestines, thus causing congestion of the bowels, liver, or stomach. ”

“ This process is repeated with every food mass as it comes through from the stomach into the intestine until, finally, usually three or four hours after the first food has commenced to come into the intestine from the stomach, the whole mass has been propelled the length of the small intestine and what is left has been passed on through into the large intestine. The small intestine is about twenty-five feet long in man; flesh-eating animals of about the same size have intestines only about one-half as long ”

“ When peritoneal adhesions that cannot be easily torn are present it may be necessary to remove the intestines with mesentery attached.
After the removal of the intestines from the body they are opened by the intestinal shears, beginning either with the jejunum or the large intestine, the cut being made in the line of the mesenteric attachment. As the intestine is opened careful attention should be paid to the contents of each portion. It is very poor technique to dilate the intestine with water or to run water through it before it is opened. ”

“ From loop lp6 the large intestine, il, extends, with gradually increasing caliber, to the cloaca, cl, a distance of 10 to 15 mm.
Except in the enlarged region near the pylorus the lumen of the intestine is almost obliterated by the folding of its thick walls, so that little or nothing can be told of its lining with the naked eye.
A distinct mesentery holds the loops of the intestine in position and binds the entire enteron close to the dorsal body wall. Because of the lack of properly fixed tissue no sections of the enteron of this stage were made. ”

“ The muscles in the colon only contract when they are stretched, so it is the volume of the fecal matter stretching the large intestine that triggers the muscles to push the waste material along toward the rectum and anus.
Eating food lacking fiber greatly reduces the volume of the chyme and slows peristalsis. But moving through fast or slow, the colon still keeps on doing another of its jobs, which is to transfer the water in the chime back into the bloodstream, reducing dehydration. So the longer chime remains in the colon, the dryer and harder and stickier it gets. ”

“ Sometimes, extremely constipated people have almost constant runny bowels because the colon has become so thickly and impenetrably lined with old fecal matter that it no longer removes much moisture. This condition is often misinterpreted as diarrhea. The large intestine's most important task is to transfer water-soluble minerals from digested food to the blood. ”

“ Not being able to move one's bowels is only the most elementary type of constipation. A more accurate definition of constipation is "the retention of waste products in the large intestine beyond the time that is conducive to health." Properly digested food is not sticky and exits the large intestine quickly. But improperly digested food (or indigestible food) gradually coats the large intestine, making an ever-thicker lining that interferes with the intestine's functioning. Far worse, this coating steadily putrefies, creating additional highly-potent toxins. ”

“ Intestinal Digestion.—The chemical changes which food undergoes in the small and large intestines are exceedingly complex. Digestion in the intestine is due to the combined action of the bile, pancreatic juice, and succus entericus. The material which enters the duodenum from the stomach is known as the chyme. The acid chyme provokes a flow of bile and pancreatic juice. It acts upon the prosecretin in the duodenal mucous membrane in such a manner that secretin, a hormone, is formed and carried by the blood to the cells of the pancreas which it stimulates. ”

“ If the constipation ends in fecal accumulation, the worst symptoms of mechanical obstruction may present themselves at any time, and death of the individual follow. The practitioner should always keep this fact in mind in treating every case of intestinal obstruction, and search for fecal impaction by examining the rectum and the whole length of the large intestine through the anterior abdominal wall. ”

“ When the large intestine is full, palpation through the abdominal wall demonstrates that the material in the lower descending colon and in the sigmoid flexure is usually composed of hard, incompressible lumps, while that in the ascending and transverse colon and the cæcum is soft, permitting the walls of the gut to be easily pushed together. ”

“ R, reticulum; C, abomasum; V.c.d., right pouch of the rumen; Ig, small intestine.
116It is by methodically observing, grouping, and classifying the symptoms presented that one is enabled to detect the links connecting them.
Intestine. The intestinal mass is contained in the right half of the abdomen above the compartment of the stomach. The large intestine occupies the upper zone, corresponding externally with the hollow of the flank from the thirteenth rib to the haunch. The small intestine occupies the middle zone from the thirteenth rib to the entrance to the pelvis and the stifle region ”

“ 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. ”

“ A physician, who understands what he is about, knows very well, when a case of this nature comes before him, that it may proceed from a variety of causes; that it may arise in the stomach from a want of digestive power, from the small intestines by a partial failure in the process of chymification; that it may depend upon the morbid action of the large intestines, or exist merely [Pg 245] as a symptom of an affection in other organs. Sedentary habits, or irregularities of diet, are causes which may be supposed to act locally on the digestive organs themselves ”

“ In the large intestines there are no villi, but the whole surface is covered with follicles which must be capable of absorbing as well as of secreting, as it is ascertained that persons can be nourished and kept alive for many weeks by nutritious enemata which do not pass into the small intestines. ”

“ In the non-acute or slowly progressing form the lesions are more abundant in the large intestines, and in some instances the walls of the intestines become so thick as a result of infiltration into their structure and the excessively thick deposits upon the lining membrane, that it becomes a matter of surprise that the passage of the ingesta has been possible and that the animal has lived so long. ”

“ The retention of fluids, transuded serum, bile, intestinal juices, and partly-altered food is hurtful. Decomposition sets in and gas is developed, which by distending the bowel causes great suffering and increases the inflammation. The movements of the intestine are not entirely under control; the patient must be fed; digestion and assimilation involve the activity of inflamed parts. The stomach can be made to do most of the work, but the sympathy of action is so close between the stomach and intestines that one cannot function without the other being excited into activity. ”

“ This is owing to the frequent concurrence of the two conditions, the gastric symptoms taking precedence of the others. The more complex nature of the intestinal function is another reason, intestinal indigestion having more modifications in its phenomena. In the stomach there is only one active secretion; in the intestine there are three, all participants in the act of solution. An alteration in the quality or quantity of one of these—the bile, for example—would lead to different symptomatic results than would follow another defective secretion, as that of the pancreas, for instance. ”

“ 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 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. ”

“ Not only do they themselves offer difficulty, but they smear over the other food masses and make it hard for the digestive juices to get at them. Although the enzyme for digesting fat is secreted by the pancreas, its successful working depends on the presence of bile from the liver. If there is an obstruction of the bile passages, so that bile cannot be poured out into the small intestine, the digestion of fats stops and, along with it to a considerable extent, all the other digestive processes of the intestine. ”

“ The weight of the bowel and its contents, along with the rapid distension of the intestine above, fixes the gut in this state of torsion and effectually prevents it from untwisting. A semi-rotation of the paretic and distended bowel about the mesenteric axis is sufficient to interfere with the supply and return of blood and provoke enteritis. Indeed, the rotation is rarely sufficiently great to produce complete obstruction, and the symptoms are frequently rather those of inflammation than of internal strangulation. ”

“ Foods to Be Avoided.—Highly seasoned foods must be avoided on account of their astringent qualities, which may cause constipation. Long, tough-fibered meats, coarse vegetables, rich foods, in fact anything which may cause intestinal indigestion, must be eliminated from the dietary. A decomposition of the foods lying in the lower part of the small intestine is dangerous to such individuals, since such products are highly toxic in character and exceedingly irritating to the already tender appendix. ”

“ 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. ”

“ Millions on millions of these glands, lacteals and follicles in the stomach and small intestines, are destroyed like the rootlets of a plant or tree in unwholesome soil. The active circulation of the digestive fluids ceases, and the sufferer is said to be costive or to have chronic diarrhea. Both symptoms are the outgrowth of many years of intestinal foulness, and indicate the degree and character of intestinal irritability and semi-starvation of the body, as a consequence of either the absorption of poisons or the excessive elimination of the vital substance of the body through diarrhea. ”

“ The intestine is straight from one end to the other but in this straight, and consequently short intestine, is a winding, cork-screw, spiral passage, through which the food, not without several circumvolutions, and, in fact, by a long route, is conducted to its exit. Here the shortness of the gut is compensated by the obliquity of the perforation.” This structure of intestine, which all the true Placoids possess, and at least the Sturiones among existing Ganoids, seems to have been an exceedingly common one during both the Palæozoic and Secondary periods. ”

“ From the important and complex function of the intestinal juices, and the very great share they take in the solution of food, there must be many phases of departure from the normal state. The processes of intestinal digestion are more intricate than those of gastric digestion, of a higher grade, and the chemical reactions are more numerous, depending upon the participation of the bile, the pancreatic juice, and the succus entericus; while intestinal absorption is a more complex act than that of gastric absorption. ”

“ It serves both as a support and as a medium of attachment to fix the intestine in its place. By its smooth, soft, and lubricated surface, it admits readily of the change of place among the bowels necessarily produced by respiration, exercise, and even by different degrees of distention of the bowels themselves. Every time we breathe, an undulating motion is communicated to the whole intestines, which facilitates their action, but which could not take place unless they were capable of gliding easily and freely over each other. ”