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treatment of myxorrhea membranacea and myxor- rhea colica and the manifold colonic lesions respon- sible for chronic diarrhea and constipation, which are often unsatisfactorily treated by dieting and internal medication. RESUME OF INTESTINAL STASIS. We are indebted to Bouchard and Metchnikoff for emphasizing the frequency with which constipation is complicated by intestinal autointoxication and Lane for pointing out the frequency and end-re- sults of intestinal stasis induced by chronic viagra in sweden boivel blocking or obstipation. Gastric or intestinal stasis may he acute or chronic, but the former is not serious because it is quickly corrected. Stasis of the viagra in sweden alimentary tract is usually encountered in the intestine (the colon and first part of the ileum) and has generally been present a long time before it is discovered or cured. Definition. — Chronic intestinal stasis is charac- terized by atony or bowel blocking wherein chyme and feces are intermittently or regularly delayed in Oct. 9, 1915] MEDICAL RECORD. 599 their downward passage, drainage is interfered with and toxins accumulate and enter the circula- tion in quantities greater than the eniunctories can eliminate to cause toxemia. Etiology. — viagra originale farmacie in svizzera The author believes that intestinal stasis may be induced by constipation {atonic, spastic, or fragmentary) or obstipation (any me- chanical obsti-uction of the bowel) where the in- testinal content is delayed and copremia ensues ac- companied by the usual manifestations of chronic intestinal autointoxication. Lane holds that con- stipation does not cause intestinal stasis, but viagra in sweden that bowel kinks, pericolic membranes, cecummobile, etc., do and are accompanied by diarrhea, which does not complicate constipation. On numerous occa- sions the writer has attended otherwise healthy neurotic and elderly patients suffering from atonic constipation who were annoyed by fluid movements when they failed to secure daily evacuations and feces were permitted to accumulate as large masses or irritating scybalse. In such instances diarrhea ceased when the offending masses had been evac- uated by laxatives and enemata. Chronic fecal impaction from any cause excites an inflammation of the mucous membrane or leads to the formation of sensitive ulcers, stercoral diar- rhea, and intestinal autointoxication. Some pa- tients become immune to fecal retention and re- main apparently well when the evacuations are from three days to weeks apart, while others suffer pro- foundly from intestinal autointoxication where the movements are delayed but a short time or the bowel is not completely emptied dailj-. Occasion- ally accumulated bacteria and their toxins result- ing from costiveness act as stimulants and ex- hilarate the patient who feels worse following emptying of the bowel. The upright posture is a predisposing cause of intestinal stasis because it puts a strain upon the gut or its mesentery and leads to the formation of adhesions that kink the bowel. In the majority of instances obstipation and intestinal stasis are caused by congenital defects, ptosis, angulations (kinks), volvulus, invagination, dilatation, diver- ticula, pericolic membranes, extraintestinal pres- sure, stricture, growths, hypertrophy of the rectal valves, sphincter ani or levator ani muscles, lesions which impede the fecal current. Pathology. — The changes which take place in and adjacent to the bowel in chronic constipation, ob- stipation, and intestinal stasis (autointoxication) vary with the etiology and duration of the obstruc- tion, but distortion of one or more of the intestinal segments is usually present and because of the de- generating effect of the accompanying toxemia structures adjacent to and remote from the intes- tine often undergo changes. Symptoms, Complicatio7is and End-Results. — The symptoms of intestinal stasis which are those ■of constipation and obstipation plus autointoxica- tion, are so viagra in sweden many and varied that the writer will not attempt more than to enumerate and casually discuss them. The chief manifestations of constipation or ob- stipation and intestinal stasis are infrequent stools, anorexia, headache, furred tongue, malaise, mental apathy, indifTerence to social or business duties, insomnia, bad dreams, foul smelling breath and perspiration, sallow or dirty complexion, dizzi- ness, palpitation, despondency, loss of weight, nausea, neurotic disturbances, subnormal tempera- ture, anemia, cold hands and feet, dyspepsia, flabby muscles, numbness, coryza, rheumatic pains, raised or viagra in sweden lowered blood pressure, hyperchlorhydria, dis- turbances of the thyroid gland, degeneration of the breasts, ptotic organs (from loss of fat), abdom- inal, pelvic, or sacral discomfort and pain, weak- ened heart action, diarrhea, reflex disturbances causing gastric indigestion and pain in and distant to the intestine, uteric, tubal, appendiceal, ovarian, and vesicular complications (involvement by adhe- sions viagra in sweden or disease). Other and more serious end-results and compli-