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Show Snortox Y1.) DISEASES OF THE ORGANS OF DIGESTION. TABLE IX. firflmnmafions, II'z/pcnrnu'u. ('mlf/csfion, L7cerati0n 0f film-(ms dlmubrrmcs of flu: Intestines. Flo. l.-‘ A portion of the small- intestine showing the several forms of redness and vascularity of the inflamed mucous membrane (A A). ramiform injection. passing into the cappillarilorm (B B). The capillariform passing into the uniform ((7 ('I). and this passing into the spotted 0r litemorrhagic (I) 1)). Flu. 2.1'uuctilorm redness (A A) of the villous structure ofthe ileum (B B). uniform redness in spots. Fin. 3.- Mechanical congestion and inflammation of the ileum,in strangulated hernia (A A), the mucous memb 'ane of a uniform deep red color (1% ll); projecting borders of the. plicze ((‘ (‘); the mucous and sub-nmcous tissues impregnated with pus (1)). mechanical congestion of the external surface of the intestine (:l‘l). peritonitis. Flo. 1.- Acute and chronic inflammation of the, colon. The chronic inflannnatiou is indicated by the slate-gray color (A A) (somcfimcs. 717.1» in this figure. rather whitish gray) of the mucous membrane. 'l‘h . acute attack, which has superveued upon the former. is seen by its red color, which is here in a lnemorrhagic or spotted form (B B). Flo. 5.-Inflammation of the peritoneum. representing the several degrees of redness and vascularity accompanied by effusion of coagulable lymph (A A) folds of the small Mescnteric tumors alone do not change its shape. but alter its position according as they draw it to one side or to the other. 'l‘uberculous and carcinomatous tumors often draw the pylorus downward and completely cover it, causing it to occupy an almost vertical position. An enlarged spleen often draws the stomach to the left: it then occupies the hilum of the spleen, and is often covered by the latter. S) intestine along the contiguous border of which the inflammation is most severe. as it always begins in these situations and extends over the exposed surface of the intestine. At B the hzemorrhagic character is shown. where the blood has penetrated into the serous membrane, in the form of dark red spots. On the adjacent fold of the intestine (C C (‘) layers of coagulable lymph are found in the shape of pseu(hi-membranes. 'l‘he inflammation in peritonitis usually begins along the contiguous margins of the neigh- boring folds of the intestine, and from thence extends in the direction where the blood vessels are distributed. Often it does not: extend backward over the intestine toward the mesentery. the portion of the peritoneum between the margins of the intestine in this situation presenting its natural color as at (D) where the folds were separated to show this apearance. llcnce it often happens that the anterior half presents all the characteristic appearances of acute inflammation, whilst the posterior halfof the intestine is to all appearance healthy. (If. (,r'ursu‘c/l.) Flo. ti.- lnflammation of the mesenteric glands accompanying ulceration of the intestine in typhoid fever. (A) portion of the small intestine laid open, (B b) ulceration of l'cyers plaques ((' )lcscntcry). (I) D) glands enlarged and in the first stage of inl'iauunation. (E I" 8) other glands presenting progressive stages of the disease, and their tcr~ nnnations. vent their contents from passing laickward. the pressure necessarily drives the lymph forward toward the heart. The quality of this highly permeable membrane. which adapts it to osmotic function, renders it peculiarly subject to extensive infiltration, especially in that portion of the intestines. where it has a very uneven surface and is provided with many sacculatcd elevations and depressions, having yielding. spongy sub-mucous strueture. 0n the slightest occasion can liypcrwmia produce infiltration into the intestinal wall. JIcr/mm'sui of Mr Smaller and Larger Inttsn'nm. The intestinal mucous membrane adapts itself to the different surtaces as to the different functions. which are carried on in its several cavities. in eavitics. which serve only as storingplaces. or as ducts. there is found only a simple stratum of tough coli- ncctiveAtissuc tibers facing the epithelium as a smooth. even layer, but sending fibrous prolongations from its nether surface into the apposinigr sub-mucous structure. and blending with it forms one tissue. But where the functions of the membrane are to secrete and to absorb. there it becomes a vast glandular structure. its free sur- face assuming enormous dimensions by forming innumerable folds, some projeeting above it.some penetrating inwardly. thus represent- ing an intricate wave-line in itshorizontal projection. 'l‘hismultiplics the pointsofcontaetofthe chymeandchylewiththealisorbingsurface. ltlrom the jejunum onward the inner intestinal surface is covered with various sized hair-like projections (rd/f). each containing in its center an absorbing lymphatic. and the connective»tissue layer between the vessels and the epithelium is of the kind of structure found in the stromaof lymph-glands. Solitary conglobatedfollicles and l'eyersplaquest>rpatchcsc<instituteadditional alisorbingarrangements. The lattcrconstitute as it \vere theflrst station where the sub- stances to be absorbed have to collect and through which they pass onward into the lymph circulation. \Vheu those substances contain any irritating material. they will at once atfect the absorbing appa- ratus: hylwrmmia. inflammation. and lrvpcrplastic processes will be found going on foremost inthose follicular structures. (ltindfleisch) Like the stomach the other portions of the alimentaljv canal are not only supplied with abundant blood circulation. and subject to periodical hyperwmia duringtheir functional activity. but also the peculiarityofvasculararrangementandthcquantitivedistributionofthcartc- rics and veins rcnderthese organs lit forthe double function of alimentation and limited respiration. During digestion a very extensive exchange of oxygen for carbonic acid is carried on not only between the oxvgen oftlle air contained in the food and the blood. but also between that ofthe blood and the carbonic acid in the tissues. As in the stomach thcadditional oxygen respircd increases the functional activitv of the secretm'y apparatus. so in the intestine both the secretory and absorbing processes are thereby enhanced. For this purpose a description of the detail of the vascular distribution in these organs may not be out of place. Frrg/ and (Irrluclr. to both of whom we owe the better ilt‘tlllilllliilllt‘t.‘ of the vascular arrange- ments in the intestines. describe them as follows: The arteries send up from the m'rrm. \vherethcy divide up in line dendroid ramifications. parallel branchlcts into the glands. In their ascent between the glands they still further sub-divide and anastomose by very nunferous inosculating vessels. thus surrounding and covering the glands with a dense capillary network. lilrom around the orifices there arise larger vessels. which.suh-dividing and forming a vascular laver in the interglamlularparts. send up vascular loops into the villi. 'l"rom the superficial part of the mucous nn-mbranc the veins are formed from intricate capillary net-works. 'l‘hcse veins quickly increase in caliber. penetrate into the deeper layers. and pass hence without taking up any branches from the glandular walls. (llenlc.) The liner the membraneous layer coveringsuch a vascular stratum the more lit is it to perform the function of osmosis and absorption: especially the more lymphatics arcdistributed within such vas» cular layer the more is absorption cl'l'cctell. l'ressure produced upon blood capillaries favors exudation and diminishes the quantity of liquid in the vessels. but upon l_\'lupliatics pressure has a contrary effect. It increases absorption. for. as their very numerous valves pre- T/rt [)IIM/i'N/lllt. Functionally the duodenum may be considered as forming part of the stomach. for here also is digestion carried on.cspecially of such substances which have not undergone suflicient change to enter into the current ot'lymph. Although not so voluminous as that of the stomach the mucous membrane in this part of the intestine has those extensive duplicatures (cu/ru/Iu‘ woodcut/cs). folds of the functional layer. placed nearly perpendicular to the axis of the tube and almost parallel to each other. lioth the muscular and mucous tunics are direct continuations of those of the stomach, and the latter tunic is readily movable upon itssuh-nmcous structure. 'l‘hestwretion ot'the gastric end of the duodenum is like that of the stonlach.of a distinctly acid reaction (ltichet). and is subject to the same class of morbid changes as the structures of the stomach (circular ulcers, self-digestion by it‘s acid secretion. etc.) From the jejunum onward the alimentary tract has more the character of an absorbing than of a digesting organ. From the colon down no digestion at all and but limited absorption takes place. \Yater.somesalincaml fattysubstanccs.non-1leptonizcdalbumen.and some peptoues are absorbed there but extremely slow. and more by simple transudation than by actual physiological action. (.ll.]l1m'/.‘- [cu/ll, Vow/i. .ll'c/i., lint. LAYV, I" 50:):1;t(le‘/lt'///}l'l"I/tl'. (Ecru/L lV/I‘r/i. .‘l/‘c/u. bid. LIA: l). ltil. Also, Jil'r/Il/u'. I'll/HAW. 771/117. (Willa/(1‘. Lire/I- lmrst. l'u/f. Err/or.) \Vhatdigestion iscarriedon in thcsmallerintes- tine is only between the pylorus and the coecum by the enteric juice which Len n and l'r/u described as an opalesccnt watery liquid of a marked alkaline reaction: of course. bile and pancreatic juice are comprised within its composition. Absorption does not take place in all parts alike. even of the smaller intestines: the difl'erence in absorbing power exists in the structural arrangement of the epithe- lium in the several parts of the mucous membrane, as Lam/Ms and Iii/our have proven by their experiments upon the individual por» tions of the alimentary canal. (Won/pf. rim/Hts, He II! sec. (Ir biol1;1//'(',1). "2) I‘t/f/llllflf/jt'lll .l/HI/o/Itj/ of t/u‘ Illics/ffit‘fi'. The morbid anatomical changes in the intestine below thestomach, although resembling by many features those of morbidly changed mucous membrane generally and that of the stomach particularly. ditfer as the diflcrcnt portions of the tract have ditlcrcnt anatomical arrangements of the essentially same structural elements. as specific alterations will necessarily follow specifically diflcrcntial morbid conditions. It is not a matter of inditlcrence to the functional activitv of the stomach that its mucous membrane. and especially the epithelial layer. is far more voluminous than that ofthc llcum. (‘ololn or even the duodenum or not: that its sub-mucous tissue is more elastic. that its muscular tissue is vastly more developed and in greater proportion.that its arteries are provided with much more abundant collateral circulation than any of the middle or lower intestines. or not. lfnot so well supplied with absorbent arrange- ments on its free surface as the small intestines. its function being more a digestive than absorbent. the dig stivc liquid of the stomach being liigblv acid. its mucous glandsarcexw-cdingly developed and wonderfully lit for pouring out thick. \‘iscid mucous to protect itself against its own gastric juice. whilst its cpithclium.of very spccdygrowth. readilv softens and becomes dissolved to form digestive syn/om n. and as is readily replaced by new epithelial structure to maintainithc histological integrity of the organ. The duodenum, less voluminously developed. both as to its mucous and other structurcs, is provided with more lymphatics and lynqdi-glands. 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