Diseases of the intestines and peritoneum / by Hermann Nothnagel ; edited, with additions by Humphrey D. Rolleston ; authorized translation from the German, under the editorial supervision of Alfred Stengel.
- Hermann Nothnagel
- Date:
- 1904
Licence: Public Domain Mark
Credit: Diseases of the intestines and peritoneum / by Hermann Nothnagel ; edited, with additions by Humphrey D. Rolleston ; authorized translation from the German, under the editorial supervision of Alfred Stengel. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
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![land finds that in the new-born child and in all mammals during the suckling stage the small intestine contains a ferment, lactase, which has the power of splitting up lactose. Hamburger and Hekma have shown the existence, in the succus entericus of man, of a ferment, erepsin, described by Cohuheim in the cat and dog, which transforms hemi- albumose into other bodies.—Ed.] In the preceding paragraphs the action on food of the different in- testinal secretions and of their unorganized ferments or enzymes has been discussed. The effect of the organized ferments—that is, of the fer- ment organisms—on the food must now be considered—in other words, the bacterial fermentation processes that occur in the intestine. Pro- teids, carbohydrates, and fats are all decomposed by micro-organisms in the intestine. A small proportion of the fat (Nencki, Blank) is decom- posed into glycerin and fatty acids, and subsequently into other acids of a smaller molecule of the fatty acid series. This process occurs in the lower portions of the small intestine. The interesting process of carbohydrate fermentation which goes on chiefly in the small intes- tine (for a detailed description of the organisms concerned see p. 48) leads to the formation of acetic, lactic, and butyric acids, alcohol, etc. (see Nencki below), carbon dioxid, and hydrogen. What proportion of the ingested carbohydrates is decomposed by these fermentative processes is as yet undetermined. The decomposition of proteids by intestinal bacteria (p. 48), usually spoken of as putrefaction, occurs only when the reac- tion of the intestinal contents is alkaline. In the early stages the bodies formed are the same as in pancreatic digestion,—namely, albu- moses, peptones, amido-acids, and ammonia,—but the process is much slower than in tryptic digestion. The process of disassimilation is carried on further and leads to the formation of aromatic oxy- and hydroparacumaric acids, which are derived from tyrosin. From these, later, paraoxyphenylacetic acid, paracresol, and finally phenol are formed by oxidation. In addition a certain quantity of phenylpropionic and of phenylacetic acids are formed. These two may also be formed directly from albumin. A second series of aromatic substances, which are not related to ty rosin, is represented by indol, skatol, and skatol- carbonic acid. [The production of indol depends largely on the activity of the colon bacillus. When carbohydrates are present as well as pro- teids, the colon bacilli ferment the carbohydrates first and no indol is manufactured until this is nearly completed. Indol is moderately toxic, and may give rise to symptoms of neurasthenia (Herter). When ab- sorbed from the intestine, it is oxidized to indoxyl and further combines, probably in the liver, to form indoxyl sulphate of potassium, which is less toxic than indol, is readily excreted in the urine, and is commonly called indican (Herter).—Ed.] Other products of the putrefaction of albumin, in addition to leucin, are the ammonia salts of capronic, valerianic, and butyric acid. These are derived from the fat nucleus of the proteid molecule. A num- ber of gases are also formed during this process of putrefactive fer-](https://iiif.wellcomecollection.org/image/b21170010_0034.jp2/full/800%2C/0/default.jpg)
