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Diseases Intestines

intestinal, intestine, mucus, catarrh, food and stools

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INTESTINES, DISEASES OF.—There are a number of affections of the intestines. The most important are CONSTIPATION (which see), intestinal catarrh, intestinal occlusion, tuberculosis of the intestine, and tumours of the intestine. Certain diseases in which the intestines are mainly involved are discussed under their respective headings. See CHOLERA ; DYSENTERY ; TYPHOID FEVER, etc.

Intestinal Catarrh.—There are two main forms of this complaint—the acute, in which recovery takes place in a few days or weeks ; and the chronic, which may extend over months or years. Among the causes of the acute type may be mentioned exposure, indiscretions in diet, and poisoning due to foodstuffs or bacterial toxins. Errors in diet are the most frequent cause, and the condition is therefore most prevalent in the summer months. Intes tinal catarrh arises in the same manner as an attack of CHOLERA MORBL'S (which see), but in the former disease the stomach is involved but slightly, or not at all. The strange fact that dietary indiscretions, and even contami nated food, may produce no symptoms in the stomach, is very likely due to the circumstance that in most persons the stomach is more resistant than the intestine. This is undoubtedly clue to the fact that the gastric juice contains hydrochloric acid, which possesses germicidal and anti-fermenta tive properties. Moreover, the stomach has the property of being able to empty itself quickly in either direction if it contains any harmful materials. In the intestine such materials remain for a longer period, and a greater opportunity is thus afforded for irritating the sensitive mucous membrane. As a rule, the disease process does not involve the entire length of the intes tine, but affects only certain portions, such as the large or small intestine, or perhaps only certain segments of these. The symptoms, however, may be very serious if only of the entire intestinal tract be involved.

The catarrhal process consists essentially of a free exudation of \voter and mucus from the inflamed membrane, together with a tendency to bleed ing. Where the lower segments of the gut are affected, this mucus may be

readily recognised, as it coats the fcal masses like varnish ; or, if the faces are soft or fluid, it makes them stringy. The higher the seat of the disease, the more intimately does the mucus become mixed with the faeces ; and in certain cases it may therefore be detected only by the aid of the microscope. Even more characteristic than the presence of mucus in the stools is the soft and thin character of the faeces. From a semi-solid consistency the evacuations gradually become quite fluid, and contain merely \voter, mucus and intestinal secretions. On account of the increased peristalsis which is characteristic of this disease, the food passes through the intestine very rapidly. The stools also contain unchanged biliary secretions ; and, instead of their normal greyish-brown colour, they appear green. In the presence of intestinal catarrh, unchanged parts of the food arc excreted within a few hours ; whereas, under normal conditions, the undigested food particles, which are too small to be readily recognised by the naked eye, do not appear in the stools until after an interval of from twelve to twenty-four hours. If this incomplete digestion continues for any length of time, nutrition becomes impaired and the body soon loses in weight. This loss is noted even where an intestinal catarrh has been present for a few days only.

The acute form of intestinal catarrh begins quite suddenly with abdominal pain, colic, and other disagreeable sensations. There may be fever, especially at the beginning of the attack. The appetite is poor, and the patients usually express an abhorrence of all food. An excessive thirst soon appears ; but this should not be satisfied, as the ingestion of any quantity of \voter simply increases the number of the stools. These may follow one another so closely that the individual is permitted scarcely any rest, and is constantly bothered by the distressing desire to empty his bowels. This profuse diarrhoea greatly \\Tokens the patient.

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