Excretory Products

Not the least important constituents of the feces are the waste products which they contain, a fact quite too often overlooked. The mucous membrane of the intestine, like the skin, is an excretory organ. Although the extent of the intestinal mucus covering is only seven square feet, about one-third of that of the skin, there is reason for believing that its importance as an outlet is fully as great as that of the skin, and probably much greater. This fact has only recently been made known. By the researches of Roger and others, it has been shown that the mucous membrane removes from the body some of the most deadly poisons which are produced in our tissues, or which may be introduced from without. If, for example, a quarter of a grain of morphia is injected underneath the skin of a person, a large part of the poison will be found in the stomach and intestine within a half hour. This excretion of poisons appears in the light of these new researches to be one of the important offices of the stomach.

Lime salts which are no longer needed in the body are excreted through the intestine.

The bile poured into the intestine contains some of the most deadly poisons produced in the body. Bouchard found the bile to be six times as toxic as the urine.

Examination Of The Stools

When a doctor is called to see a sick infant, he first of all inquires as to the bowel passages, and the experienced nurse or mother always preserves the infant's napkins to show to the doctor when he comes. If the bowel passages have the usual consistency and yellowish color and a slightly acid odor, the doctor knows that there is no serious disturbance of digestion; but if the stools are dark or brownish in color and have a foul or putrid odor, this fact alone is sufficient to show to the physician or experienced nurse that the infant is sick. Any physician who would omit to examine the stools of an infant when called in consultation, would be regarded either as ignorant or as quite remiss in his duty.

It is very strange indeed that until quite recently almost no attention has been given to the stools of adults, and even at the present time physicians quite rarely take the trouble to make anything like a thorough investigation of bowel passages. The doctor usually contents himself by inquiring if the bowels move regularly. When questioned concerning the character of their stools, most patients are unable to give any information. Something can be learned from the general appearance of the stools, but for really useful information it is necessary to submit a specimen to a thorough laboratory investigation at the hands of an expert in this particular line of research.

It is not going too far to say that a thorough examination of the stools should be made in every case of chronic disease. This practice has already been instituted in a few medical institutions where a high degree of medical work is done, and the time cannot be far distant when such an examination will be a routine practice with all physicians who attempt to keep abreast with the advance of medical science.

Influences Which Excite Movements Of The Colon

The food tube is controlled by two sets of nerves. One, the motor, excites contractions of the intestine, while the other opposes this action, causing cessation of movement and relaxation of the intestine. The motor nerves are derived from the brain and spinal cord; those of the second class, known as splanchnic nerves, from the sympathetic.

A very remarkable and interesting fact relating to the action of these nerves should be mentioned here as an aid to a full understanding of their action. When the motor nerves of the intestine are stimulated, they cause powerful contraction of both the intestine and the abdominal walls, but relaxation of both the internal and external anal sphincters. When the sympathetic or splanchnic nerves of the intestine are stimulated, they cause relaxation of the intestines, with cessation of movement, and at the same time strong contraction of the ileocecal sphincter. These two facts explain many important phenomena in relation to bowel movement and constipation.

The relaxation of the anal sphincters when the colon and abdominal muscles contract, is necessary to facilitate the discharge of feces from the bowels. This fact wholly agrees with the interesting observations of Bayliss and Starling, that mechanical excitation of the intestine causes contraction at and above the point of irritation, and relaxation below, a most beneficent and wonderful adaptation of means to ends.

One more important fact is especially worthy of note in this connection, viz., that the intestine is supplied with nerve ganglia of its own, located within its walls, between its two layers of muscles, so that it may act even when all cerebro-spinal and sympathetic nerves are cut in experiment or paralyzed in disease. A small bit of stomach or intestine removed from a living animal, when stimulated by electricity does not contract in continuous spasm as do ordinary muscles, but contracts rhythmically, as does the heart and other involuntary muscles. This is true, however, only when the nerve ganglia are removed with the muscle tissue.