Diseases of the stomach and intestines / by Robert Coleman Kemp.

  • Kemp, Robert Coleman, 1865-
Date:
1910
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the stomach and intestines / by Robert Coleman Kemp. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    peristaltic waves increase during advanced digestion. At intervals the pylorus relaxes and the contraction squeezes part of the chyme into the duodenum. Cannon^ finds that carbohydrates pass out soon after ingestion and require only about one-half the time that proteids do for gastric digestion. Fat when taken alone remains for a considerable time in the stomach, and if combined with other food its exit is dela)^ed. It is believed that chemic stimuH, such as hydrochloric acid, control the opening and closing of the pylorus. If atony of the stomach be present, motor insufficiency and stasis result, and the latter favors fermentation and putrefaction. It has been demonstrated that the presence of hydrochloric acid in con- siderable quantities does not prevent these conditions if stasis be present. INTESTINAL DIGESTION Under normal conditions, when the chyme enters the duodenum its reaction is acid. It is here subjected to the influence of the bile, pancreatic juice, and intestinal secretions, all of which, in their action, have a more or less close interdependence upon each other. Bile.—The bile in the intestine precipitates the pepsin from the chyme. This, however, is soon dissolved. Others hold that albu- minoids are precipitated from the chyme, together with the pepsin, and are then more readily absorbed. It does not have a deleterious effect on the pancreatic digestion. The bile is one of the chief factors in gradually altering the reaction of the chyme to neutral or alkaline, and it strongly supplements the action of the pancreatic juice in emulsifying fats, and its absence or diminution lessens this function. Pawlow believes that it may augment slightly the effects of the other pancreatic ferments. One of its chief functions is undoubtedly excretory, and through it many of the useless products of metabolism are eliminated. When absorbed into the system it acts as a poison and produces a definite toxemia. The bile is a clear, tenacious mucoid fluid with an alkaline reaction, consisting of water, bile-acid salts (glycocholic and taurocholic acid), pigments (bilirubin and biliverdin), mucin, cholesterin, lecithin, soaps, fats, etc.; about 500 to 600 cc. are excreted in twenty-four hours. Wm. H. Porter^ believes that the precipitation of the pepsin from the chyme through the action of the bile is necessary for the action of the pancreatic ferments, and the enterokinase of the intestinal juice, as the pepsin, as long as it remains active, inhibits their action. Some consider that it has antifermentative and antiputrefactive powers, and that it helps to maintain the nutrition of the epithelial 1 American Journal of Physiology, 1904. - Indicanuria a Danger Signal, Postgraduate, 1907.