0, then beware; those wounds heal ill that men do give themselves. - Shakespeare.

The tractus intestinalis possesses three original segments - gastrium, enteron, colon - which differ in form and dimension, anatomy and physiology; however, every segment possesses the four common visceral functions - sensation, peristalsis, absorption, secretion.
 

    The physiology of the tractus intestinalis is peristalsis, absorption, secretion and sensation; its object is to afford general corporeal nourishment.  One or all of the functions, the physiology of the tractus intestinalis may present pathologic physiology without demonstrable pathologic anatomy.
A typical example of pathologic physiology in the tractus intestinalis is emesis, e. g., by some, from the observation of a fly in the soup.  This is disordered function introduced so rapidly that pathologic anatomy had insufficient time to become established.  The so-called reflexes are pathologic physiology not pathologic anatomy.  One may observe pathologic physiology where a herd of cattle is placed on a boat and when the boat starts the cattle become excited, nervous, a number having immediate and frequent liquid stools.  The peristalsis and secretion of the tractus instestinalis liquefying the feces and expelling them-pathologic physiology but not pathologic anatomy was detectable.  A typical example of the utility of pathologic physiology in the tractus intestinalis is the diarrhea of puerperal sepsis - which frequently saves the patient.  Certain kinds of food produce pathologic physiology.  It is an excessive fermentation - gas.  This may be observed the most certainly in the digestion of leguminous substances, e. g., beans.  Pathologic physiology may be manifest by excessive, deficient or disproportionate peristalsis, absorption, secretion and sensation.  The practitioner observes and treats the following conditions.

(1).  PERISTALSIS (EXCESSIVF, DEFICIENT, DISPROPORTIONATE).

    The tractus intestinalis possesses peculiar physiologic movements known as peristalsis, vermicular motion passing through periodic activity and repose.  Though each segment (gastrium, enteron, colon) possesses peristalsis in common, however, the structure, function and object of each segment is so different that peristalsis in each segment - gastrium, enteron and colon - is best studied separately.  The factors which initiate motion in the tractus intestinalis are: (a) blood supply; (b) ingesta; (c) secretion; (e) temperature; (f) sensation.
    (a)  Excessive peristalsis (stomach).  Increased gastric movements (pathologic physiology) may arise from excessive secretion of HCl, hence excessively rapid gastric evacuation.  Increased gastric movements or contractions may arise from pyloric obstruction.  Gastric, enteronic and colonic peristaltic unrest may be prominent without known cause, with perhaps an irritable defective nervous system-a kind of motor neurosis.  The splanchnic nerves are perhaps the chief motor nerves of the digestive tract.  The peristaltic unrest (pathologic physiology) is eminently manifest in certain individuals as evidenced by the frequent gurgling, splashing sounds heard when standing in close proximity.  During fright excessive intestinal peristalsis may occur with sudden evacuation of the colon.  Excessive peristalsis may occur during pregnancy or on observation of disgusting matters (as a fly in the soup), intense decomposing odors, certain forms of food create peristaltic unrest.  The frequent wild and disordered peristalsis in the digestive tract of the child is based on pathologic physiology - not pathologic anatomy.  It rests on disordered peristalsis due to the fact that Auerbach's plexus is not fully developed or established in office.  The cramps, and colic and emesis, diarrhea, arise and disappear so quickly that insufficient time exists for pathologic anatomy.  Vomiting is pathologic physiology as it forcibly, artificially dilates the cardiac sphincter of the stomach.
    (b)  Deficient peristalsis.  The most typical example in the tractus intestinalis of deficient peristalsis is constipation - the so-called sluggish bowels.  Evacuation of the digestive tract (especially the stomach and colon) is defective, incomplete.  Dilatation of the stomach (generally due to compression of the transverse duodenum by the superior artery vein and nerve) results in series of consequences as decomposion, fermentation, taxemia, inability to force food through the pylorus.  The acute gastric dilatation is simply an exacerbation of a previous dilatation.  I have shown in numerous cadavers that no pyloric obstruction exists, that it is gastro-duodenal dilatation due to compression of the mesenteric vessels.  Gastro-duodenal dilatation is a stage of enteroptosia.
    (c)  Disproportionate peristalsis consists of non-uniform, irregular, disordered muscular movements.  It is peristalsis uncontrolled like the irregular invaginations of death and the test of diagnosis is that the invagination is not pathologic anatomy-simply pathologic physiology.

(2).  SECRETION (EXCESSIVE, DEFICIENT, DISPROPORTIONATE).

    (e)  Excessive secretion, pathologic physiology is observed in diarrhen.. Many kinds of irritating foods induce it.  Doubtless excessive secretion is due to the variations in HCI.  Chronic supersecretion, is perhaps connected with superacidity.  Excessive secretion of the tractus intestinalis it frequently found in neurotic patients, in neurasthenics, in hysteria.  Hunger plays a role, e. g., when a hungry subject views food.  Abdominal secretion occurs in chronic dyspepsia.  Hypersecretion doubtless depends on the blood volume in the stomach, enteron or colon.  Hypersecretion frequently accompanies gastroptosia (which is generally gastro-duodenal dilatation) because the gastroptosia is accompanied by stagnation of food material and irritates the gastric wall.  The fasting stomach may present supersecretion on reception of food known as alimentary supersecretion.  Hyper chloridia from an unknown cause.  Infectious processes induce supersecretion as well as ulceration and epithelial desquamation.
    In the duodenum, the most important segment of the tractus intestinalis, arrives the extra glandular secretion succus pancreaticus, and succus bilis.  These naturally abundant extraglandular secretions, when possessing the pathologic physiology of excess, will present a wide varying zone of effect on nutrition.  The excess of biliary secretion, pathologic physiology, is difficult to estimate as the bile is re-absorbed and its excessive flooding stream prevents the formation of biliary concrements.      However, we know that in driving cattle several miles previous to slaughter an excess of bile collects in the cholecyst - demonstrating a wide range of variation in the time and quantity of biliary secretion.  Excessive biliary secretion may be the cause of glycosuria allowing insufficient time for completion of processes.
    The pathologic physiology of excess of pancreatic secretions are equally difficult to estimate with that of biliary.  Excessive succus pancreaticus practically prohibits pancreatic calculus. (Enteron and colon) excess of enteronic and colonic secretion is apparent in diarrhea, in fluid evacuations.      Abnormal, excessive intestinal secretions are not well understood.  The pathologic physiology of excessive intestinal secretion rests chiefly on the kinds of chemistry of food and bacteria within the digestive canal.  The multiplication of bacteria incites the intestine to extra secretion.  The abnormal bacteria process may continue within the intestinal lumen.  The number of bacterial residence usually constitute about one-third of the weight of the dry fecal masses.  It is evident from this view that bacteria are a necessary part of the tractus intestinalis of higher organisms.  The child's tractus intestinalis possesses a bacterial flora by the fourth day of extrauterine life.  Excessive colonic secretion, pathologic physiology, is well known in mucous colitis, or what I considered better termed, secretion neurosis of the colon.
    (f)  (Stomach) deficient secretion of the tractus intestinalis constitutes a frequent condition of pathological physiology.  The most evidently marked state of deficient intestinal secretion is constipation.  Deficient secretion of HCI, the most significant secretary gastric function in the stomach, may exist, indicating malignancy, chronic gastritis, infectious disease, acute functional disease, presenting a wide zone of pathologic physiology.  Deficient HCI is especially noted in gastric carcinoma. (Stomach) deficient secretion HCI changes the bacterial process, as normal gastric secretion is doubtless antiseptic.  The most important means to check microbic process in the stomach is continuous movements of food and frequent evacuations.  With deficient HCI the bacteria multiply in stagnating stomach contents increasing lactic acid, which favors bacterial growth.      Deficient HCI enhances the decomposition of albumen in  the  enteron  and  colon.   Abundant  bacterial  decomposition  from  deficient  HCI produces products which irritate the gastric mucosa, inducing pain, colic vomiting, defective appetite, gas.
 

ABDOMINAL BRAIN AND COELIAC PLEXUS       Fig. 115.  This figure presents the nerves of the proximal part of the tractus intestinalis, that is, the nerve plexuses accompanying the branches of arteria coeliaca.  1 and 2 abdominal brain surrounding the coeliac axis drawn from dissected specimen.  H. Hepatic plexus on hepatic artery.  S. Splenic plexus on splenic artery.  Gt Gastric plexus on gastric artery.  Rn. Renal artery (left).  R. Right renal artery in the dissection was rich in ganglia.  Dg. diaphragmatic artery with its ganglion.  G. S. Great splanchnic nerve.  Ad. Adrenal.  K. Kidney.  Pn. Pneumogastric (Ltleft). Ep. Right and Eps. Left epiploica artery. St. Stomach Py. Pyloric artery.  C. Cholecyst.  Co. Cliole-dochus.  N. Adrenal nerves (right, 10, left, 10).  The arterial branches and loops of the coeliac tripod (as well as that of the renals) with their corresponding nerve plexuses demonstrate how solidly and compactly the viscera of the proximal abdomen are anastomosed, connected into single delicately poised system with the abdominal brain as a center.  Hence local reflexes, as hepatic or renal calculus, disturb the accurate physiologic balance in stomach, kidney, spleen, liver and pancreas.  Food in the duodenum (or HCI) will induce: (1) the bile to flow; (2) the succus entericus to flow; (3) the duodenal glands (intestinal - especially Brunner's) to flow; (4) secretion to flow - all from the same duodenal stimulant (food or HCI), presenting a delicately poised nervous apparatus.

    (Duodenum).  The business segment of the digestive tract is the enteron into which flows the succus bilis et succus pancreaticus.  Deficient biliary secretion may manifest itself by clay colored stools, by icterus, by calculus obstructing biliary flow.  Pathologic physiology in deficient biliary secretion presents a frequent and an extensive range of action.  Deficient biliary secretion occurs with deficient amounts of appropriate food, hence the necessity of rational dietetics.  Deficient biliary secretion lays the foundation for the most distressing of hepatic diseases - hepatic calculus.  The deficient hepatic secretion induces a limited quantity of bile with a slow stream allowing ample opportunity for crystallization and the formation of biliary concrements.  The hepatic calculus consists chiefly of cholesterine and calcium salts of bilirubia.  Naunyn has demonstrated that the quantity of cholesterine and calcium salts of bilirubin are independent of the kinds of ingesta, hence to I prevent biliary concrements we must employ visceral drainage to maintain such salts in mechanical suspension and irrigate, flood, them onward by powerful, large biliary streams.  For dissolving cholesterine the bile possesses powerful agents in cholate, sapo, adeps.  Since cholesterine appears in the bile as crystal, or in combination with desquamated epithelial cells, the powerful, large biliary stream from ample visceral drainage will flood, irrigate, the precipitated collected crystals and concrements into the duodenum.  Deficient biliary flow is liable to become stagnant, favoring bacterial growth and bile channel infectiori because the volume of bile stream, being diminished, does not excite the biliary channels to vigorous peristalsis and consequent defective flushing of the bile passages occurs.  Deficient biliary secretion is accompanied by the pathologic physiology of diminished bile stream; stagnation of bile from diminished biliary peristalsis; defective irrigation of the biliary passages; the precipitation, formation of cholesterine and calcium and bilirubin crystals or concremenis; infection of the biliary passages, insufficient quantity of bile for digestion (clay colored decomposed stools), icterus from obstruction of bile passages and changed direction of bile stream calculus in the biliary channels may produce disease only when infection arises or the calculus becomes clamped (pain, colic).  Inflammation (cholecystitis) creates violent peristalsis of the biliary channels and hence projects the calculus in various directions until it is finally impressed, engaged, whence pain and colic.
    In icterus the bile with its coloring material becomes transfused through the body, in the blood and lymph - presenting typical pathologic physiology.  Icterus depends on complete closure of the ductus choledochus communis but it may depend on hepatitis.  For the origin of icterus the kind of disease is less significant than its seat.
    Deficient pancreatic secretion is diagnosed by the undigested fat in the stools.  In 700 personal autopsic inspections I observed but one complete failure of pancreatic secretions.  This subject possessed a carcinomatous invasion of the ductus choledochus and ductus pancreaticus, producing complete obstruction of both ducts.  In ten weeks the patient lost 113 pounds.  The biliary passages (exclusive of the cholecyst) were dilated seven times their original caliber and the ductus pancreaticus was dilated some 20 times its original caliber.  The pancreas possesses two exit ducts, patent perhaps in 60 per cent of subjects.  If one becomes obstructed the other acts vicariously for both.
In the above cited case Santorini's duct no doubt conducted succus pancreaticus into the duodenum.  Deficient secretion from the pancreas arises from partial and complete obstruction of its ducts by calculus, neoplasm, or by degeneration of the organ.
    Deficient secretion in the enteron is not understood.  Deficient secretion in the colon results in the well known disease, constipation.  The central nervous system, as well as the abdominal sympathetic, is influential in diminishing secretion.  In fact, the pure results of constipation are preponderating, psychic and subjective.  The assimilation of the individual constipation does not suffer materially; however, defecation is laborious and the care for the evacuation and anxiety as to food selection increases the neurosis; with the evacuation the head becomes free, the voice becomes cheerful, the effect is mainly suggestive.
    (g)  Disproportionate secretion is where the secretions of the segments of the tractus intestinalis are irregular, non-uniform, disordered.  When such disordered secretions mingle, fermentation occurs with consequent tympanitis meteorismus.  The gastric secretions may be disproportionate, resulting in disordered digestion.  Biliary secretion may be excessive, pancreatic secretions deficient, thus making secretions disproportionate, and the same conditions may occur in the enteron and colon.

(3.)  ABSORPTION (EXCESSIVE, DEFICIENT, DISPROPORTIONATE).

    (h)  Excessive absorption of the digestive tract is difficult to demonstrate.  However, it is conceivable that the absorptive apparatus of the tractus intestinalis might work excessively, absorbing substances which injure the system.  Decomposing ingesta, bacterial products, toxines, may be too rapidly absorbed.  Excessive absorption induces constipation.
    (i)  Deficient absorption in the tractus intestinalis is not infrequent.  We notice this factor when the food passes per rectum undigested.  Excessive peristaltic movements may be so rapid that insufficient time is allowed absorption.  Deficient pancreatic secretion does not prepare the fats sufficiently for absorption - hence deficient absorption, pathologic physiology, may rest on many factors, neurosis, excessive or deficient peristalsis, unsuitable ingesta, infection.
    (j)  Disproportionate absorption occurs but is difficult to demonstrate the non-uniform, unequal, disordered absorption of the three segments - gastrium. enteron, colon.

(4.)  SENSATION (EXCESSIVE, DEFICIENT, DISPROPORTIONATE).

    Excessive gastric sensation (hyperesthesia of mucosa) not infrequently arises.  The healthy subject notices the digesive organs only when hunger arises or the gastrium becomes excessively occupied with ingesta or gas; one might state that it is a distinct function of the tractus intestinalis to manifest hunger.  The physical condition is also of direct influence.  Hunger and distension of the stomach are related because subjects afflicted with super activity manifest hunger shortly after ingesting meat, which is rapidly evacuated through the pylorus, leaving an empty stomach with recurring secretions.  Hunger and appetites do not always correspond. One may feel hungry but does not eat, as the appetite fails.  The Scotch poetry tells much of a story.

Some have meat but cannot eat,
Some can eat but have no meat.
 

X-RAY OF DUCTUS BILIS AND DUCTUS PANCREATICUS       Fig. 116.  Presents the relations of the biliary and pancreatic ducts.  These ducts are ensheathed by a nodular network, or anastomosing, fenestrated meshwork of nerves ruling finely poised balanced physiology dominated by the abdominal brain.

    It is possible that activity of both motion and secretion induces appetite which has a wide zone of pathologic physiology.  In excessive sensation or gastric hyperesthesia the sensation of gastric pressure or fullness in eating arises sooner than it does in the healthy, in fact sooner than the stomach becomes full.  Occasionally one meets a patient who on taking ingesta experiences gastric pain - this may be neuralgia, superacidity, ulceration, carcinoma, pergastric peritoneal adhesions.  The superacidity, irritable gastric muscularis may experience pain from direct effects on the sensitive nerves, i. e., superacidity induces muscular colic.  The fearful "gastric crises" in tabes and the other spinal affections is founded on degeneration and irritation of the vagus.  It is well known that certain individuals are supersensitive not only in general but as special organs, e. g., some will vomit on seeing a fly in the soup.  From sensitive stomachs appear to arise dizziness, sensory waves, neuralgia, anomalies of cardiac innervation.  Also unclear functional disturbances - however I would suggest that such attributes of numerous disturbances rather belong to the abdominal brain.  The innumerable "gastric reflexes" are receptions, reorganizations and emissions of the abdominal brain.  Vomiting, sooner or later after ingesta, may occur from hyperesthesia of the gastric mucosa.  I have had several patients with excessive sensation, or hyperesthesia, of the gastric mucosa.  One patient vomited shortly after taking food for fourteen years.  Her stomach absorbed sufficient to maintain a fair condition of flesh.  Another vomited for two years almost immediately after eating.  Excessive sensation in the gastric mucosa presents a wide zone of pathologic physiology in the various degrees of vomiting during gestation.  Many subjects possess an extraordinary delicacy and sensitiveness in regard to the stomach.  If such subjects exercise care in selection of food and prudence in eating they remain relatively healthy.  This pretended and acquired idiosyncrasy is annoyingly manifest in practice when we are continually meeting people who cannot take certain kinds of food, as eggs, milk, graham bread, fruits, etc., etc., such patients cannot live in an ordinary boarding house.  Either by heredity or chiefly by habit the employment of certain kinds of food have a wide range of pathologic physiology.  The psychical state perhaps plays the preponderating role of idiosyncrasy of foods.  The so-called nervous dyspeptic experiences all kinds of sensations in the stomach.  There is no structural change in the stomach to correspond to all the functional manifestations - it is pathologic physiology.  The crawling of animals within the stomach and tractus intestinalis may be interpreted as ingesta or gas passing over the hyperesthetic or supersensitive mucosa.
    (l)  Deficient sensation in the tractus intestinalis doubtless explains the so-called sluggish bowel, the constipation.  The absorption of the food is insufficient.  It is not uncommon for patients to tell me that the bowels are dead, no feeling in them.
    (m)  Disproportionate sensation is non-uniform, irregularly located hyperesthesia and anesthesia of the mucosa in the different segments of the digestive tract - gastrium, enteron, colon.  In sensation of the tractus intestinalis, excessive, deficient or disproportionate, there is no relation between anomalies of function and anatomic structure.  Anomalies of function may present no recognizable anatomic changes - it is simply pathologic physiology.  The gastric mucosa rapidly changes at death, hence cautious examinations are required in autopsies.  As regards the relations between the kind of anatomic changes and functional disturbances, we are but little informed by any investigations.

PATHOLOGIC PHYSIOLOGY OF THE TRACTUS NERVOSUS IN REGARD TO THE TRACTUS INTESTINALIS.

    The tractus nervosus influences two spheres, viz.: corporeal and mental.  The nervous system extends to the deepest and most profound secrets of life - mental and physical, hence, it possesses the highest differentiation of all visceral tracts.  The functions of the tractus intestinalis vary within a wide zone of pathologic physiology, e. g., many subjects pass a week without defecation or subjects may practice defecations daily.  The tractus intestinalis is preponderatingly controlled by the abdominal sympathetic or nervus vasomotorius.  It requires a decade for the nervus vasomotorius to
 

DUODENUM WITH ITS TWO DUCTS - BILIARY AND PANCREATIC       Fig. 117.  Illustrates the duodenum, the most important segment of the tractus intestinalis, receiving the ductus bilis and ductus pancreaticus.  The nervous system controlling the secretion of the tractus intestinalis must be delicately poised, balanced, as the secretions of one gland (as the liver) is a complement of the secretion of another gland (as the pancreas).  The succus pancreaticus multiplies the power and utility of the bile in digestion if the two glandular secretions become mixed immediately on entrance into the duodenum.

establish its control, its more independent rule.  The wild and disordered peristalsis of a child is due to the cerebrum and Auerbach's ganglionic plexus not being completely balanced, in control.  A child is frequently subject to peristaltic unrest, intestinal invagination (pathologic physiology).  Frequently not long before death in adults the cerebrum and Auerbach's ganglionic plexus lose their complete balance (especially the cerebrum being less influential) and the invagination of death arises.  I have observed 4 to 6-inch invaginations in subjects - absolute pathologic physiology - no pathologic anatomy.  Though the function of the nervus vasomotorius is beyond the control of the will, digestion proceeds in spite of us or while we sleep.  The five abdominal visceral tracts (tractus genitalis, urinarius, intestinalis, lymphaticus, vascularis) exist in an exquisitively balanced or poised state, hence, the so-called reflexes, from one visceral tract to another, accomplished through the nervus vasomotorius, exert extensive influence in producing pathologic physiology - yes many conditions of pathologic physiology arise in different visceral tracts.  The essential conditions of a reflex are: (a) an intact sensory periphery (receiver); (b) an intact ganglion cell - pelvic or abdominal brain - (reorganizer); (c) an intact conducting apparatus (transmitter).  A pure reflex consists of a sensation transmitted to a reorganizing center which emits it over a motor apparatus.
    A reflex is independent of will.  The abdominal viscera are not only intimately connected, associated by means of the tractus vascularis, tractus lymphaticus, tractus nervosus but especially by the peritoneum.  Any excessive irritation in any one of the exquisitively poised visceral tracts immediately unbalances the others - at first producing pathologic physiology and perhaps later pathologic anatomy.  Hence the sensory apparatus in each visceral tract is significant.  The reflex from one visceral tract to the other disorders: (a) the blood circulation; (b) lymph circulation; (c) absorption; (d) secretion; (e) peristalsis; (f) sensation.  E. G., when the gestation contents distends the uterus, uneven expansion stimulates, irritates the sensory apparatus of the uterus.  The sensation is transmitted over the plexus interiliacus and plexus ovaricus to the abdominal brain where reorganization occurs whence the stimulus is emitted over the plexus gastricus to the gastrium with end results of excessive gastric peristalsis and vomiting.  Other abdominal visceral tracts are likewise effected by this uterine reflex, but do not manifest such prominent symptoms as vomiting.  Vomiting is pathologic physiology.  Ordinary function as gestation will induce pathologic physiology in the tractus intestinalis by: (a) reflexes; (b) robbing it of considerable blood - the extra amount required for the tractus genitalis to gestate the child; (c) instituting indigestion and constipation, from limited blood supply.  A calculus in the tractus urinarius (ureter) will produce numerous reflexes with consequent pathologic physiology in the several abdominal visceral tracts - viz.: disordered peristalsis, absorption, secretion, sensation - not pathologic anatomy.

TREATMENT OF PATHOLOGIC PHYSIOLOGY OF THE TRACTUS INTESTINALIS.

    Since pathologic physiology is the zone between physiology and pathologic anatomy it should be practically amenable to treatment.  First and foremost, the diagnosis should be made and the cause removed, as a ureteral calculus, anal fissure, hepatic calculus or any point of visceral or dietetic irritation.  The most essential feature of subjects suffering from pathologic physiology of the tractus intestinalis is deficient visceral drainage.  The blood is excessively waste-laden from insufficient elimination.  The secretions are scanty.  The urine is concentrated, its crystallized salts are evident to the eye.  The skin is dry from insufficient perspiration.  Sleep is defective from the bathing of the innumerable ganglia with waste laden blood.  Constipation, deficient urine, limited perspiration, capricious appetite and insomnia characterize subjects with pathologic physiology of the tractus intestinalis.  For many years I have applied a treatment to such subjects which I term:

VISCERAL DRAINAGE.

    Visceral drainage signifies that visceral tracti are placed at maximum elimination by dietetics, fluids, appropriate hygiene and habitat, exercise. The waste products of food and tissue are vigorously sewered before new ones are imposed.  The most important principle in internal medication is ample visceral drainage.  The residual products of food and tissue should have a maximum drainage in health.  I suggest that ample visceral drainage may be executed by means of: (A) fluids; (B) food.
 

X-RAY OF DUCTUS BILIS, DUCTUS PANCREATICUS AND ARTERIA HEPATICA       Fig. 118.  Illustrates the vast nerve supply it requires to ensheath the channels of the liver and pancreas with a nodular network, a fenestrated meshwork, of nerve plexuses.  The tractus nervosus of the tractus intestinalis is solidly and compactly anastomosed.

(A.) Visceral drainage by fluids.

    The most effective diuretic is water.  One of the best laxatives is water.  One of the best stimulants of renal epithelium is sodium chloride (1/2 to ¼ physiologic salt solution).  Hence I administer 8 ounces of half normal salt solution to a patient six times daily, 2 hours apart.  Note - NaCl is contraindicated in parenchymatous nephritis. 48 ounces of 1/2 normal salt solution efficiently increases the drain of the kidney, it sustains in mechanical suspension the insoluble uric acid, it stimulates other matters, it aids the sodium, potassium or ammonium salts to form combination with uric acid, producing soluble urates.  The 1/2 normal salt solution effectively stimulates the peristalsis and epithelium of the tractus intestinalis inducing secretions which liquify stool, preventing constipation.

(B.) Visceral drainage by foods.

    The great functions of the tractus intestinalis - peristalsis, absorption, secretion - are produced and maintained by food.  To drain the tractus intestinalis foods which leave an indigestible residue only are appropriate.  Rational foods must contain appropriate salts whose bases may form combinations which are soluble as sodium and potassium combined with uric acid and urates to form soluble urates.  The proper foods are: cereals, vegetables, albuminates (milk, eggs), mixed foods.
Meats should be limited, as they enhance excessive uric acid formation.  In order to stimulate the epithelium of the digestive tract (sensation) with consequent increase of peristalsis, absorption and secretion, I use a part or multiple of an alkaline tablet of the following composition: Cascara sagrada (1/40 grain), aloes (1/2 grain), NaHCO₃ (1/2 grain), KHCOL₃ (1/3 grain), MgSO₄ (2 grains). The tablet is used as follows: One-sixth to one tablet (or more, as required to move the bowels once daily) is placed on the tongue before meals and followed by 8 ounces of water (better hot).  At 10 A. M., 3 P. M., and bedtime 1/6 to 1 tablet is placed on the tongue and followed by a glassful of any fluid.  In combined treatment 1/3 of (NACI) the sodium chloride tablet containing 11 grains and (1/6 to 3) alkaline tablets are placed on the tongue together every 2 hours followed by a glassful of fluid.  This method of treatment furnishes alkaline bases (sodium and potassium and ammonium) to combine with the free uric acid in the urine, producing perfectly soluble alkaline urates and materially diminishing the free uric acid in the urine.  Besides the alkaline laxative tablet increases the peristalsis, absorption and secretion of the intestinal tract, stimulating the sensation of the mucosa aiding evacuation.  I have termed the sodium chloride and alkaline laxative method the visceral drainage treatment.  The alkaline and sodium chloride tablets take place of the so-called mineral waters.  I continue this dietetic treatment of fluid and food for weeks, months, and the results are remarkably successful in pathologic physiology.  The urine becomes clarified like spring water, and increased in quantity.  The tractus intestinalis becomes freely evacuated, regularly daily.  The blood is relieved of waste laden and irritating material.  The tractus cutis eliminates freely, and the skin becomes normal.  The appetite increases.  The sleep becomes improved.  The patient becomes hopeful, natural energy returns.  The sewers of  the body are well drained and flushed.