Chemical Factors in the Toxemia of Intestinal Obstruction

The characteristic chemical changes in the blood in acute pyloric and upper intestinal tract obstruction are an increase in the nonprotein nitrogen, a decrease in the chlorides, and a rise in the carbon dioxide combining power of the plasma. These observations serve as an index of the profound disturbance taking place in the tissue cells and fluids of the body. The rise in the nonprotein nitrogen of the blood is probably due to two factors: (1) the concentration of the blood plasma from the great fluid loss, and (2) the great increase in tissue destruction taking place as shown by the marked increase in nitrogen excretion.1The protein destruction may result from the dehydration of the tissue cells or possibly from the action of some circulating toxic factor. The fall in chlorides is partly due to the loss of chloride as hydrochloric acid through vomiting. Dragstedt2has shown