'INTESTINE, BOWEL, or GUT, the ali mentary tube, in the higher animals limited to that portion between the stomach and the out let at the anus. The human intestine is divided into the small and large intestine, the two parts varying in structure, movement and function. The small intestine starts at the pylorus of the stomach, as the duodenum, and the first 8 or 10 inches are so distinguished. This portion is the widest and most deeply placed of the parts of the small intestine.. About three or four inches. below the pylorus the ducts of the gall-bladder and pancreas open conjointly into the bowel. The duodenum emerges from the cover of the peritoneum and becomes the jejunum. The re mainder of the small intestine constitutes the jejunum (about two-fifths) and the ileum. Be tween these divisions, there is little difference, except that the jejunum is more freely movable, occupies the upper left portion of the abdomen more than the lower and right, and.has walls. The lumen of, the small intestine grad ually grows less from the where it is two inches and a half in diameter, to little more than an inch where the ileum empties into the large intestine. The ileum is inserted sev eral inches above the actual beginning of the large intestine,' so that a blind pouch is formed below the point of juncture; this pouch, called the csecum, gives off the appendix vermiformis (see APPENDICITIS) from its lower and back part. From the icascum the large bowel passes• up 'to the under surface 'of the liver as the ascending colon (see Cotow), thence across the abdomen below the lower border of the stomach as the transverse colon, turns down to the iliac fossa as the descending colon, forms a peculiar S-shaped curve, the sigmoid flexure, which passes over the brim of the pelvis, where it is called the rectum (q.v.). The large bowel is about six feet in length. Both bowels have four coats, the mucous coat, the submucous, the mus cular, and over most of the bowel an invest ment of peritoneum forming the serous coat. In the small intestine the mucous membrane is thrown up into permanent folds, each extending over half-way around the inside of the bowel. In this way a large surface is exposed for the absorption of food. Furthermore, the inner surface is covered with finger-like projection called villi, each having a large absorbing ves sel in its centre. At the bases of the villi are tubular (of Lieberkuhn) and branching glands (of Brunner) that dip down into the mucous membrane. Scattered over the surface there are tiny collections of lymphoid tissue, called soli tary follicles, and here and there collections of these follicles into groups one to three inches long, called Peyer's patches. It is these spots that are attacked and ulcerated in typhoid fever. The muscular coat consists ip an inner layer running around the bowel and an outer longi tudinal coat. The large bowel differs from the small in the absence of the folds and villi, and, is but slightly movable within the abdomen, be ing bound down to the abdominal wall pos teriorly by the peritoneum. See PHYSIOLOGY., Diseases of the Intestine.— These may disturbances of the function of the bowels without actual inflammation, or they may be inflammations in different parts and of different kinds; but with inflammations there is neces sarily a disturbance of the various functions, and differentiation frequently becomes a matter of difficnIty4 Diarrlicca and constipation (qq.y.)
are symptoms of many different conditions, as are also deficiencies of secretion and absorp tion. The nervous mechanism of the bowels may be changed, giving rise to abnormal sensa tions and disturbances of all the functions. True inflammation of the intestines is the most common cause of abnormal action, and there fore is described in detail.
Acute Intestinal Catarrh is an inflammation of the mucous membrane that varies much in its symptomatology with the part of the bowel affected and the causative agent. Among the causes may be mentioned the eating of tainted fruits and other foods; the overeating of any food; overdrinking, particularly of very cold liquids; the injection of chemical or mechanical Irritants; "catching cold"; and the poisons of the infectious diseases. The bowel is inhabited by numerous forms of micro-organisms, many of which are entirely harmless; but when any of the various agencies mentioned above affect the mucous membrane, the micro-organisms art able to attack the damaged surface. Man \ forms of bacteria produce particular types of disease when they find such lodgment, because they invade the system with their peculiar products. (See 'CHOLERA INFANTIJM ; CHOLERA ; DYSENTERY). But to the growth of bacteria must always be ascribed some of the symptoms in any intestinal catarrh. The attack usually starts in acutely with fever, general bodily discomfort and abdominal pain. If the inflammation be confined to the upper part of the small intes tine there may be constipation; but this is un common, and diarrhoea is the rule. Inflamma tion of the small intestine is spoken of as en teritis, but this is usually associated with more or less inflammation of the large bowel, called colitis, although it may occur alone even in its last portion, the rectum. The pain in colitis is apt to be confined to the sides of di, abdomen, and when the inflammation is loN% down there is constant desire to defecate, pain accompanying the act. Passage of mucus alone also indicates 'an inflammation low down in the rectum. The stools in acute intestinal catarrh vary much, with the cause of the trouble; in some observed cases of dysentery the dis charges are like rice-water. Treatment of these conditions depends upon the severity and loca tion of the inflammation. The mild cases, with ordinary loose movements, recover without medication with abstinence from food for 24 hours. Castor-oil or small doses of calomel will cleanse the intestine of irritating sub stances. The more severe cases are kept in bed and allowed small amounts of milk after the first day, and arc given small doses of castor Oil or mixtures of bismuth, opium and other sedative drugs. If the large intestine is found to be involved, irrigation with common salt in water (teaspoonful to the quart) is valuable. Great care must be used in the selection of diet for sortie time.