THE LETHAL AGENT IN ACUTE INTESTINAL OBSTRUCTION

The continuous appearance in clinical journals of papers which purport to discuss the cause of death in acute intestinal obstruction, but which entirely ignore or misconstrue the important experimental work carried on in the last few years, especially by L. R. Dragstedt and his co-workers, suggests the desirability of a brief review of this field. Particularly vexed have been the questions of the nature of the poison (for all workers agree that a poison taken up from the obstructed intestine is the lethal agent) and its source.

Whipple and his collaborators¹ have shown that the formation of a closed loop of the upper intestine, by double section, infolding the cut ends of the isolated segment after thorough washing, and reestablishing continuity of the remaining intestine by anastomosis, is equivalent to a simple obstruction. An animal on which such an operation has been performed dies in a manner typical of