Vagotonia; a clinical study in vegetative neurology / by Hans Eppinger and Leo Hess. Authorized translation by Walter Max Kraus and Smith Ely Jelliffe.

  • Eppinger, Hans, 1846-1916.
Date:
1917
Catalogue details

Licence: Public Domain Mark

Credit: Vagotonia; a clinical study in vegetative neurology / by Hans Eppinger and Leo Hess. Authorized translation by Walter Max Kraus and Smith Ely Jelliffe. Source: Wellcome Collection.

    44/108 (page 36)
    the inconsistency between the amount of the ingested food and the amount of the stool. This latter is usually hard, dry, marble- shaped and scanty. This is due to the fact that there is increased absorption of the chyme. In many cases, the small masses of stool are covered with mucus and seem wrapped in fat. This suggests an increased secretory activity on the part of the lower bowel, particularly since this condition so nearly approaches that of mucous colitis or a membranous enteritis. This latter is surely to be regarded as a secretory neurosis of the intestine since atropin has such a markedly beneficial action upon it. The condition known as eosinophilic catarrh of the intes- tines is probably related to this disease and perhaps this is similar to bronchial asthma with its sputum rich in eosinophiles. If we wish to attempt an explanation of spastic constipation in terms of autonomic stimulation, we must not forget that an important factor in this disease is an increased absorption of chyme, or a decreased production of mucus by the intestines. It need only be recalled here that the intestine will push forwards a large marble introduced into its lumen better than a small one, of which it can scarcely get rid. The probability that spastic states play a part is increased by the fact that atropin can rarely be dis- pensed with in these cases. Most probably the autonomic stimuli influence the activity of the intestine through an action upon the circular musculature, much in the same way as they do in in- creased stomach tone. Just to what degree autonomic stimuli play a part in increasing absorption of chyme [better absorption or digestion] remains to be investigated. It is possible that these autonomic stimuli cause an increased production of ferments. Spastic constipation is often combined with spasm of the sphincter recti. This latter is often the principal complaint of the patient, and may in itself disturb the emptying of the bowel, owing to fear of the pain produced by defecation. We have noticed this symptom where there was neither fissure nor rhag- ades. These cramps in the rectum may be increased by cer- tain diseases such as tabes, or may be the most important symp- tom of the disease, or may attract attention as a solitary symptom —coming in the form of crises. Disturbances of the rectum are not infrequently associated with disturbances in other parts controlled by the pelvic nerve. Those patients who complain not only of spastic constipation