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Related post: experiences with normal stomach contents are men-
tioned by Riegel (15) and others, but none as far
as I can learn have been reported with the contents
of patients with gastric dilatation.
II. THE INTESTINAL GASES.
What are the sources and varieties of the intes-
tinal gases? While Zuntz (16), Ruge (17), Tap-
peiner (18), Tacke (19), Planer (20), and others
have made some investigations into the nature and
origin of these gases, their researches have been
limited to animals or to experimental deductions
from examinations of the expired air. To the best
of my knowledge, careful studies and investigations
in the human being into the exact causes, place, and
manner of development of the intestinal gases, as
well as into the influence of dietetics, medication,
physiological measures, etc., upon them, have not
been made or published. Hence, while we have
some positive knowledge, much that is stated in the
textbooks, and of what follows here, is purely de-
ductive and theoretical.
The gases found in the intestinal tract are de-
rived from the following three sources: i. They en-
ter the bowels from the stomach ; 2, they pass into Buy Dimenhydrinate Online
it by diffusion from the blood ; 3, they are formed
within the gut itself. This last is the most important
source.
1. The gases that enter the bowel from the stom-
ach may be any or all of those already mentioned
as occurring in the latter organ.
2. Nitrogen, according to Buiige (21), and car-
bon dioxide, according to Notlinagel (2), pass into
the intestinal lumen by diffusion from the blood.
3. Most of the intestinal gases, however, are
BASCH: GASTRIC AND INTESTINAL GASES.
687
formed in the bowel, and this production of gases
takes place more or less constantly through fermen-
tation, bacterial decomposition, and, in the upper
part of the small intestine, through the chemical
decomposition of the alkaline carbonates of the pan-
creatic, biliary, and intestinal secretions by the acid
chyme and the fatty acids." Gas production is live-
liest where there is active fermentation, and slowest
where putrefactive changes and inspissation of faecal
contents occur. Generally speaking, therefore, the
greatest amount of gas is formed in the upper por-
tion of the small intestine, less so in the lower, and
little or none in the large intestine. A marked ex-
ception to this rule is found in conditions of hyper-
peristalsis without obstruction. Here the contents
are rushed through so rapidly that gas formation is
practically uniform throughout the entire gut.
It is obvious that the nature, quantity, quality,
and preparation of the food, and the digestive activ-
ity of the alimentary Purchase Dimenhydrinate secretions are intluential fac-
tors in the production of gases. Under ideal condi-
tions of food preparation, ingestion, and digestion,
the kind and quantity of gases will vary greatly
from those arising under abnormal conditions.
The carbohydrates yield hydrogen, Purchase Dimenhydrinate Online carbon diox-
ide, marsh gas, and other hydrocarbons, the last
named group of gases varying in amount in inverse
ratio to the digestibility of the carbohydrate.
Ruge (17), Tappeiner (18), and Planer (20) have
shown that those rich in cellulose yield more hydro-
carbons than does any other variety of food. Since
cellulose is resistant to the gastrointestinal secre-
tions of man, the production of marsh gas and simi-
lar compounds must Order Dimenhydrinate be the result of bacterial action.
Carbohydrates rich in starch and poor in cellulose
yield little hydrocarbon, but much carbonic acid
gas.
The proteids develop relatively less carbonic acid
gas than the carbohydrates, but, they yield, in addi-
tion, hydrogen, marsh gas, nitrogen, ammonia, and
sulphuretted hydrogen, and, under certain condi-
tions, nitrogen. Ruge (17) has shown that under a
pure meat diet, the intestinal gases of man contain
very large amounts of marsh gas (26.45 P^r cent.).
It was formerly held that the greater part of
the intestinal gases passed out by the anus. This
view is now known to have been erroneous, and it
is conceded that in the healthy individual, at least, as
much disappears through absorption into the blood
and expulsion by the respiratory tract. This is
proved by the fact that, although gases are formed
continuously in the healthy individual, Buy Dimenhydrinate little or none
escapes through eructation or by the anus, while the
condition of intestinal distension remains pretty con-
stant. Consequently, a large part musi be absorbed,
and escape by w'ay of the lungs. This has been
proved by experiment. Thus Tacke (lO), with rab-
bits in Zuntz's laboratory, found that in these ani-
mals ten to twenty times as much of the intestinal
gases escapes through the lungs as per anus. The
ratio for human beings is not known.
The formation and elimination of these intestinal
gases arc intimately associated with body metabol-
ism. Under normal conditions the study of these
processes has only theoretical interest. When, how-
ever, there is an overproduction or a difficulty in
their elimination, clinical conditions that may be
associated with the gravest consequences to the pa-
tient may result.
Abnormally large amounts of gas Order Dimenhydrinate Online in the bowel
may result from causes disassociated with the integ-
rity of that organ. Among these are the swallow-
ing of excessive quantities of air, or perhaps, too, of
carbonated beverages. In the latter case, the gas

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