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May 1914


Author Affiliations


From the Department of Surgery of the Cornell University Medical College.

Arch Intern Med (Chic). 1914;XIII(5):701-736. doi:10.1001/archinte.1914.00070110030003

Intestinal obstruction in man, if unrelieved, speedily causes death. The fatal outcome is too rapid to be the result of starvation, and three general theories have been advanced to explain it:

  1. A disorder of the nervous mechanism controlling the cardiac and vasomotor systems.

  2. A bacterial infection of the organism by the passage outward of bacteria from the intestinal lumen.

  3. An intoxication from poisonous substances imprisoned in the intestine orally to the obstruction.

Two modifications of the last theory have recently come into prominence. The first was originally advanced by Vidal,1 and more recently elaborated by Maury Draper2 (formerly Draper Maury), in which the presence of a substance in the upper intestinal tract was believed to exist, which, unless neutralized by substances elaborated lower down, entered the system as a poison.

The second modification is advanced by Whipple, Stone and Bernheim.3 These workers

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