EXPERIMENTAL HIGH JEJUNOSTOMY IN THE DOG, WITH BLOOD CHEMICAL STUDIES

1. The effect of high jejunostomy upon the life and chemical changes of the blood of dogs is here reported. 2. Sodium chloride solution administered in sufficient quantity after high jejunostomy prolongs the life of dogs. 3. Such experimental findings as these warrant a careful cinical study of the effects of high jejunostomy so frequently used in the treatment of acute intestinal obstruction

THE CHLORIDE CONTENT OF THE TISSUES OF THE DOG AFTER EXPERIMENTAL GASTROINTESTINAL TRACT OBSTRUCTION

Comparative observations are reported on the chloride content of the blood, liver, and muscle of the dog after obstruction of the upper gastrointestinal tract. After obstruction of the pylorus there is a marked fall in the chloride content of the liver, and a slight fall in the muscle. Similar changes are observed after obstruction of the jejunum. With obstruction of the cardiac end of the stomach no change was observed

THE EXCRETION OF NITROGEN AFTER UPPER GASTROINTESTINAL TRACT OBSTRUCTION

After obstruction of the cardiac end of the stomach and after obstruction and release of the pylorus there is a marked increase in non-protein nitrogen excretion. This increase is due to accelerated protein destruction, which may result from the great fluid loss, or to the action of some toxic body

EXPERIMENTAL DEHYDRATION: CHEMICAL CHANGES IN THE BLOOD OF THE DOG CONTRASTED WITH THOSE FOLLOWING OBSTRUCTION OF THE CARDIAC END OF THE STOMACH

A comparative chemical study of the blood and the urine of the dog with experimental dehydration and with obstruction of the cardiac end of the stomach is reported. The average duration of life is slightly longer with dehydration than with obstruction. The urine output per kilo of body weight is almost twice as great in dehydration as with obstruction. The increase in non-protein nitrogen and urea nitrogen is much the same in the two groups although somewhat more marked with obstruction. The chlorides of the blood are markedly increased with dehydration and slightly decreased with obstruction. The increase in fibrinogen and total protein is twice as great with obstruction as with dehydration. These findings indicate that there must be some factor or factors in addition to dehydration producing the toxemia of cardiac obstruction

EXPERIMENTAL OBSTRUCTION OF THE JEJUNUM : EFFECT OF SODIUM CHLORIDE INTRODUCED DIRECTLY INTO THE LUMEN OF THE INTESTINE BELOW THE POINT OF OBSTRUCTION.

Chemical changes are reported occurring in the blood of animals with obstruction of the jejunum, in which distilled water or sodium chloride solutions were introduced directly into the lumen of the intestine below the point of obstruction. Distilled water given daily from the beginning of the obstruction, had no influence on the development or course of the toxemia. 1 and 2 per cent salt solutions prevented a toxemia in uncomplicated cases. One animal so treated lived 30 days. Distilled water, given after the onset of toxemia, did not alter the progress or outcome of the toxemia. 10 per cent sodium chloride solution, administered after the onset of toxemia, controlled it in most cases for a long period. Hydrochloric acid had no effect on the course of the toxemia

THE EFFECT OF INORGANIC SALTS ON THE CHEMICAL CHANGES IN THE BLOOD OF THE DOG AFTER OBSTRUCTION OF THE DUODENUM

The chemical changes in the blood of dogs treated with various inorganic salts after obstruction of the duodenum are reported. Two dogs treated with sodium chloride survived approximately six times as long as the average untreated animal, one living 22 days, the other 24 days. Ammonium chloride was found to produce an acidosis. The administration of potassium chloride, calcium chloride, and magnesium chloride did not prevent the usual rise in non-protein nitrogen and fall in chlorides, and the fatal outcome. Iodides seemingly hasten the toxic process. Sodium bromide appears to have an inhibitory action upon it, but much less than that of sodium chloride. Sodium sulfate, magnesium sulfate, sodium citrate, monosodium phosphate, and disodium phosphate failed to alter the course of the intoxication. Atropine and pilocarpine were without therapeutic value in preventing the changes characteristic of intestinal obstruction

THE SODIUM CONTENT OF THE BLOOD OF THE DOG AFTER EXPERIMENTAL INTESTINAL OBSTRUCTION

Sodium determinations on the blood of ten dogs after experimental obstruction of the jejunum are reported. The average sodium content of the plasma of the normal dog is 336 mg. per 100 cc. There is relatively little change in the sodium content of the blood plasma after the intestine is obstructed, even with marked changes in the chloride and bicarbonate. The whole blood sodium tends to rise after intestinal obstruction. The increase in bicarbonate ions does not fully compensate for the decrease in chloride ions. After intestinal obstruction there is a larger amount of sodium in some unknown combination than in the normal dog. These findings throw no definite light on the mechanism of the increased protein destruction characteristic of intestinal obstruction

CHEMICAL FINDINGS IN THE BLOOD OF THE DOG AFTER CLOSED-LOOP OBSTRUCTION OF THE JEJUNUM

The chemical findings in the blood of 6 dogs with closed-loop obstruction of the upper jejunum are reported. The duration of life with closed loops is less than with simple obstruction. All animals showed a marked rise in non-protein nitrogen and urea nitrogen, and fall in chlorides. Usually the C02 combining power of the plasma is increased. The findings in closed-loop obstruction are essentially the same as in simple intestinal obstruction

THE OXYGEN CONTENT OF THE VENOUS BLOOD OF THE DOG AFTER UPPER GASTROINTESTINAL TRACT OBSTRUCTION

There is a rapid fall in the oxygen content of the venous blood of the dog after upper gastrointestinal tract obstruction. This increased deoxidation is probably due to a combination of several factors. There is much evidence to suggest that active reducing bodies are present in the blood

THE EFFECT OF SODIUM CHLORIDE ON THE CHEMICAL CHANGES IN THE BLOOD OF THE DOG AFTER OBSTRUCTION OF THE CARDIAC END OF THE STOMACH

A study is reported of the effect of different methods of treatment on the toxemia of cardiac obstruction. The average duration of life of untreated dogs is 3 days. Three dogs treated with 1 per cent salt solution subcutaneously lived 32, 36, and 45 days respectively without developing a toxemia. 2 per cent glucose similarly given, does not alter the course of the toxemia. Concentrated salt solution in small quantities given directly into the jejunum prevents the marked rise in non-protein nitrogen but does not materially prolong life. Release of the obstruction does not change the course of the toxemia in untreated animals. The subcutaneous injection of 1 per cent sodium chloride solution after release of the obstruction causes a rapid return of the blood to normal and allows the animal to recover. A similar amount of fluid given as 2 per cent glucose does not alter the course of the toxemia after release of the obstruction