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September 15, 1923


JAMA. 1923;81(11):931-932. doi:10.1001/jama.1923.02650110061021

The severity of the symptoms that follow acute intestinal obstruction or injuries to the bowel that may simulate this condition often seems to exceed what the mechanical factors involved might warrant. The most striking fact is that prompt recovery by no means always attends the removal of the obstruction, so that it has become customary of late to assume an intoxication of widespread physiologic effect as the result of the production of some sort of toxin in the damaged areas. The possible nature and precise etiology of the intoxication still remains in doubt, one of the differences of opinion involving the question of bacterial intervention, as has already been pointed out in The Journal.1

Several years ago, Cooke, Rodenbaugh and Whipple 2 observed that cases of acute intestinal obstruction, whether produced experimentally in animals or occurring in man, are regularly accompanied by a rapid rise in the nonprotein nitrogen