An Address ON CHRONIC INTESTINAL STASIS: "AUTOINTOXICATION" AND SUB-INFECTION: Delivered before the Medical Society of the City and County of Denver, Denver, Colorado
Authors: J. G. Adami
Journal: BMJ (1914)

STEADILY anid piogressively dluring the last score or so of years there hias developed a tenidency to ascribe to dlerangement of the intestinal tract the origi21 of nlot a fewv grave disorders, until to-day we lhave Sir Arbutlhniot Lanel recordinig nio fewver tlhani seventeen imiore or les-s outstanding symiiptoms as directly due to stasis and (lelayed passage of faecal m-latter thirouglh tlle lower end of tlle ileumii and the larger bowel, together witli nine maladies indirectly due to the same cause, whlile we are informed thlat these are merely tlle lmlore important possible outconmes of stasis; several otlhers nmay a1soDb.imputed to this cause.it is a portentous roll-a roll so long that we may well call a halt andc examine into its details.SIR ARBUTHNOT LANNE'S THESIS.Let me, as this is to form the text for my sermon, rapidly recapitulate Lane's conclusions:By clhronic intestinal stasis, says Sir Arbuthnot, lie means that the passige of tlle contents of the intestinal canal is delayed sufficienutly long to resuilt in the pro-(diuction, in the snilall intestine especially, of an excess of toxic muaterial, alnd in tlle absorption into the circulation of a greater quantity of poisonous products than tho organs whlichl convert and excrete tllem are able to deal with.In consequence there exist in tlhe eirculation materials wlich produce degenerative clhanges in every single tissue of the body, and lower its resisting power to invasioln by deleterious organisms.He ascribes these disturbances primarily to delay of faecal miiaterial in thle large bowel.Tllis loading of tlhe large bowel tenids towards downward displacement and dragging upoln tlle othler organs in the abdominal cavity.Along the lines of stress tlherc develop definite mnenm- branes; tllese very m6imbranes, by ptulling upoin' tlle otlher organs, indiluce kinkls anid partial obstructions, and llere tljis obstruction tells upon the smiall bowel dilata- tion oceIurs above the point of obstrutction, witl a relative stasis.Tlhus we find brouglht about a delayed passage of the contenits of time smiiall initestine, as also of the dluodenum and tlhe stomiiaclh, with resuLltant infection of these organs and afenumulation. of deleterious bodies from the stagrnatilng inaterial.He enumerates tlle following as the symptoms -which resuLlt directly froin the "; autoinitoxication " of clhrolnic intestinal stasis:1. Loss of fat. 2. Wasting of botlh voluntary and(1 invi-olLutary mmjscles.3. Alteration in the texture an(d coloutr of the skini, withi pig- mentation and offenisive perspiration.4. Suibnlormal temperature, especially affectinig the extremi- ties.There is nio abruipt linie of separationi betwveen this coil- (lition and Rayinaud's disease, of which it would appear to be a stage.5. Mental conditions of apatlhy, stuipidity, or misery, wlichl miiay become exaggerated to a state of melanlcholia, or even app)parent imbecility, w-ith suicidal telndencies.There mav be neuiralgic symptoms, neuritis, frequent headlacle, joss of con- trol over the temper.These nervous states due to stasis are a mulchl more frequienit cause of serious crime thati is generallN iltnai tired.6. Rtlhetumatic aclles and pains i n mutsclles, joints, a-nd skin.i. Atroplhy of the thyroid gland(.8. Either inierease(d or lowere(d blood pressure, 9. Degenerative changes in the breasts, especially ihi the UI)l)ic anid outer zonie of the left lbreast.predisposing to caticer.O.-'Prolapse of abdominal organs, partly hecause of loss of fat, partly becauLse of wastedn muscle fibres.Increased inobility of the kidney s, atid prolapse aiid bend's of the uterus.11. Breathlessness oIn exertioni, at timnes of astlhmlatic type, (lme in sonic cases to a dlistenisioni of the stomach andl inte3titmes.12. Degcleeration of tme heart miuscle with dilatationi of left E TnF.B:RITISHA .l FJOT RNAT.I / 7lheart aid aorta aiid arterio-sclcrotic chlalnges (atieroii:iatons) in the svstemic arteries.13. Renal clhaniges wvhich are romiilily grouped -tinder thic term "r 13riglit's disease." 14.Early loss of lhair colotnr wvitht fallilng ouit, mllore colmml-lon in those witlh darli tlianl withl red hair.15. Affectioins of the pancreas witlh clhroniic iidturationi, iniflammation.anid finallv cancer.Pancreatic diahetes.16. Inifection. of the l)iliary system, c'holecystitis, cliole- lithtiasis, canicer, togetlher itlh mnany actute anld-clhronfic, diseases of the liver.17.Degenerative diseases of tihe eve.The indirect chianges resultina frolmi the low(vered resist- inig power of thle tissuds can, says Sir Arbnithinot, hardly be separated abruptly from these moic lirect cblanges.Of these the most obviouis are:1. Infection of the gums and pyorrhoea alv-eolaris.2. Tuberculous inifection othier than that due to direct inoculation, as througlh the skin.