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Article
June 9, 1923

ACUTE INTESTINAL OBSTRUCTIONWITH SPECIAL REFERENCE TO PARALYTIC ILEUS FOLLOWING ABDOMINAL OPERATIONS

JAMA. 1923;80(23):1666-1669. doi:10.1001/jama.1923.02640500008003
Abstract

In 1909 and again in 1913 I1 published two papers on the subject of acute intestinal obstruction. Since that time I have been keenly interested in the clinical phase of this subject as it has arisen in patients coming under my own observation, and also in the voluminous published reports on this subject.

In reviewing the literature, one is amazed at the conflicting reports pertaining to the fatal factor in acute intestinal obstruction. This is strikingly illustrated in the extensive review by Ellis.2

Nesbitt,3 in 1899, in a study of the content above the occlusion, found that food rich in lecithin resulted in cholin and neurin, and he believed that neurin was the responsible fatal factor in acute intestinal obstruction.

Buchbinder,4 in 1900, showed that the intestinal wall is not permeable to bacteria until a severe degree of gangrene develops, or until injury is produced in

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