Intestinal Obstruction

Whipple, Stone, and Bernheim I studied the cause of death in dogs with high intestinal obstruction, by producing a closed loop of the duodenum, beginning just below the pancreatic ducts and ending beyond the suspensory ligament. This portion was isolated from • the remainder of the intestinal tract by tying a heavy ligature tightly at these two points, and burying it under an inverted layer of the peritoneum. A gastro-enterostomy was then done. Dogs so treated died in from thirty-six to seventy-two hours. The authors inferred from this that there developed in the closed loop a poisonous material, the absorption of which caused death. Since the closed loop contained neither gastric secretion, bile, nor pancreatic juice, the conclusion seemed inevitable that some alteration in the loop function was responsible for death. A series of careful and well controlled experiments was then undertaken to study the nature, and if possible, to determine the source of the poison. The method employed was to-produce the isolated loop, collect the cor~tents, sterilize them by heating to 60 ° C., filtering them, and then, after autolysis, to inject them into a healthy dog, intravenously, subcutaneously, or intraperitoneally. It was demonstrated in this way that dogs so injected died promptly. Further, the authors were unable to isolate such a poisonous material from the normal intestine by any method o f treatment; and if the mucosa of the loop were first destroyed by a fluoride, the poisons did not appear. Lastly, some dogs died within a few days, when the loop was drained externally, there being an absorption directly from the mucosa, and not from the lumen.