Diseases of the Large Intestine
Diseases and abnormalities of the large intestine are far too numerous to be described in one paper; I shall discuss, therefore, only the more common conditions that may be encountered in the routine examination of the gastro-intestinal tract.
The normal contour and position of the colon, as well as many of the abnormal positions that it may assume, are familiar to all physicians. It may not be so well known, however, that a transverse colon that crosses the upper part of the abdomen is more or less rare. In the majority of cases, one finds that the colon falls well below the umbilicus, and it is not unusual to find a transverse colon with its midpoint below the urinary bladder. In many cases the rotation of the colon is incomplete; frequently the embryonic stage is not fully resolved. The normal sigmoid flexure is generally from 16 to 17 inches long (40.6 to 43.1 cm.), but this length may vary, a redundant sigmoid sometimes being several feet in length. Doubtless some cases of obstipation are due entirely to this redundancy. The dilated colon, also, is often a source of difficulty. At the present time, extensive work is being done in an effort to prove that, in some cases at least, colonic stasis is directly responsible for arthritis, stasis being apt to occur, of course, when the colon is dilated, spastic or redundant. The intestinal activity is accelerated in the presence of hyperthyroidism, and diarrhea may be expected to occur; conversely,. . .