Blood Chemistry and the Gastrointestinal Tract
Much of the progress that has been made in medicine during recent years has been due to the development and clinical application of microchemical methods for the examination of the blood. Through chemical studies of the blood our viewpoint concerning the nature of some of the most serious disturbances of the gastrointestinal tract has been entirely changed and the treatment of such disorders has been revolutionized, with great advantage to the patient. The clinical conditions in the case of which blood chemistry studies are most important are those conditions which are associated with disturbances in motility accompanied usually by an abnormal loss of the gastrointestinal secretions, such as: (I) obstruction of the (a) small intestine, (b) pylorus, and (c) esophagus; (2) vomiting without obstruction; (3) fistula of the upper intestinal tract; (4) prolonged diarrhea from any cause; (5) paralytic ileus; and (6) acute peritonitis.
In all of these various clinical conditions a rather characteristic toxemia is present and in all of them, also, the chemical changes which take place in the blood and urine are of a somewhat similar nature. Intestinal obstruction is a condition which is found frequently and has been intensively studied for many years. Long before it was known that characteristic chemical changes take place in the blood, the toxemia of intestinal obstruction was considered to be due to the absorption of putrifying organic material from the lumen of the obstructed gut. Hartwell and Houget in 19101 concluded that dehydration was the most important factor in the. . .