下痢の病理解剖

抄録

1. Diarrhea was defined by the author as evacuation of fluid stool to avoid the confusing use of the vast concept.
2. Among 90 autopsy cases exclusive of primary intestinal diseases, caecal content demonstrated in 72 cases approximately the consistency of soft stool, in 10 cases that of rice gruel and only exceptionally in 8 cases that of fluid.
3. Average daily water absorption in colon of Japanese adults was roughly estimated to be 100 ml, calculated from average daily stool amount (150g), its water content (75%) and average water content of caecal stool (85%)
4. From these data, it was concluded that disturbance of large intestine alone does not cause diarrhea, but disorder of small intestine is prerequisite to it.
5. Eight out of the 90 autopsy cases, which all died from other than intestinal diseases, contained in colon no usual stool, but only fluid content. And all these 8 cases except 1 demonstrated clear-cut histologic changes of small intestine.
6. Diarrhea, a nomen actionis derived from δια(through)-ρεω(flow) has hitherto been regarded as a morphologically unapproachable action. However, the colonial state of containing no usual stool but only fluid content is nothing but the phenomenon, diarrhea.
7. Morphological approach to diarrhea in autopsy was first made possible by this new interpretation.
8. It was thus presumed by the author that biopsy methods might discover organic injuries of small intestine even in common diarrhea as is encountered in daily life.
9. Histologic investigation of small intestine from autopsy cases is perfectly practicable if due caution is paid, as is demonstrated in the histologic pictures of this report all taken from autopsy cases.
(picture 1, 2, 4, 8: Normal. Picture 9, 10, 11, 12: Cases with fluid content in colon.)
(picture 3, 5, 6, 7: Salmonella Enteritis.)