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EXPERIMENTAL HIGH INTESTINAL OBSTRUCTION: Title and subTitle BreakRELIEF BY IRRIGATION AND CONTROL OF ALKALOSIS: PRELIMINARY REPORT FREE

MILTON M. PORTIS, M.D.; BERNARD PORTIS, M.D.
JAMA. 1925;85(8):574-576. doi:10.1001/jama.1925.02670080018006
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Acute duodenal obstruction is now assuming great importance because of the performance of more radical gastric surgery and of the newer conceptions of alkalosis and gastric tetany. We have attempted in this experimental study to produce an artificial duodenal obstruction and to remove the toxic substance by irrigation and to determine the relative importance of the involved factors.

The literature contains numerous reports regarding high intestinal obstruction and the effects caused by closed loops of intestine at different levels. Neuman1 first described the usual syndrome in 1861, and Kussmaul2 later confirmed his observations. Many have observed a profound and even rapidly fatal intoxication caused by substances formed in an obstructed bowel. The higher the obstruction, the more rapid and toxic the picture. Obstructions in the duodenum are rapidly fatal.

All are agreed that the severe reaction following high intestinal obstruction is due to some highly toxic substance. The

REFERENCES

Neuman, quoted by Kussmaul (Footnote 2).
Kussmaul: Deutsch. Arch. f. klin. Med. 6:455, 1869;.
Whipple, G. H.:  Proteose Intoxication , J. A. M. A. 67: 15 ( (July 1) ) 1916;.
Cooke, J. V.; Rodenbaugh, F. H., and Whipple, G. H.: J. Exper. Med. 23: 717 ( (June) ) 1916;.
Whipple, G. H.: J. Exper. Med. 23:123 ( (Jan.) ) 1916;
25:479 (March) 1917.
Dragstedt, L. R., and Dragstedt, C. A.: J. Exper. Med. 25:439 ( (March) ) 1917;
Dragstedt, C. A., and Dragstedt, L. R.:  Acute Dilatation of the Stomach , J. A. M. A. 79:612 ( (Aug. 19) ) 1922;
Am. J. Physiol. 46: 584 ( (Aug.) ) 1918;.
Draper, J. W.:  Intestinal Obstruction , J. A. M. A. 67:1080 ( (Oct. 7) ) 1916;.
Davis, D. M., and Stone, H. B.: J. Exper. Med. 26:687 ( (Nov.) ) 1917;.
Hausler, R. W., and Foster, W. C.:  Studies of Acute Intestinal Obstruction: Different Types of Obstruction Produced Under Local Anesthesia , Arch. Int. Med. 34:97 ( (July) ) 1924;
 Acute Strangulation , HauslerArch. Int. Med. 34: 697 ( (Nov.) ) 1924;.
Haden, L. R., and Orr, T. G.: Bull. Johns Hopkins Hosp. 34: 26 ( (Jan.) ) 1923;.
Saito, S.: Mitt. a. d. med. Fak. d. k. Univ. zu Tokyo 31:117, 1924;.
Dixon, C. F.:  Value of Sodium Chlorid in Treatment of Duodenal Intoxication , J. A. M. A. 82:1498 ( (May 10) ) 1924;.

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Neuman, quoted by Kussmaul (Footnote 2).
Kussmaul: Deutsch. Arch. f. klin. Med. 6:455, 1869;.
Whipple, G. H.:  Proteose Intoxication , J. A. M. A. 67: 15 ( (July 1) ) 1916;.
Cooke, J. V.; Rodenbaugh, F. H., and Whipple, G. H.: J. Exper. Med. 23: 717 ( (June) ) 1916;.
Whipple, G. H.: J. Exper. Med. 23:123 ( (Jan.) ) 1916;
25:479 (March) 1917.
Dragstedt, L. R., and Dragstedt, C. A.: J. Exper. Med. 25:439 ( (March) ) 1917;
Dragstedt, C. A., and Dragstedt, L. R.:  Acute Dilatation of the Stomach , J. A. M. A. 79:612 ( (Aug. 19) ) 1922;
Am. J. Physiol. 46: 584 ( (Aug.) ) 1918;.
Draper, J. W.:  Intestinal Obstruction , J. A. M. A. 67:1080 ( (Oct. 7) ) 1916;.
Davis, D. M., and Stone, H. B.: J. Exper. Med. 26:687 ( (Nov.) ) 1917;.
Hausler, R. W., and Foster, W. C.:  Studies of Acute Intestinal Obstruction: Different Types of Obstruction Produced Under Local Anesthesia , Arch. Int. Med. 34:97 ( (July) ) 1924;
 Acute Strangulation , HauslerArch. Int. Med. 34: 697 ( (Nov.) ) 1924;.
Haden, L. R., and Orr, T. G.: Bull. Johns Hopkins Hosp. 34: 26 ( (Jan.) ) 1923;.
Saito, S.: Mitt. a. d. med. Fak. d. k. Univ. zu Tokyo 31:117, 1924;.
Dixon, C. F.:  Value of Sodium Chlorid in Treatment of Duodenal Intoxication , J. A. M. A. 82:1498 ( (May 10) ) 1924;.
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