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Abstract The extensive literature on the treatment of paralytic ileus and the constantly increasing number of methods for inducing intestinal motility indicate the lack of a satisfactory therapy for intestinal atonia. Recent attention has been directed toward acetylcholine and its probable function as the chemical mediator of parasympathetic nerve impulses. As such, it has been considered as an agent initiating gastro-intestinal motility, and attempts have been made to treat both experimental and clinical paralytic ileus with this preparation. It has been shown, however, that acetylcholine has an extremely evanescent action and that it is rapidly destroyed in the body by a specific ferment (esterase) which splits the ester into acetic acid and relatively inactive choline. Physostigmine salicylate in extremely high dilutions has been found to inhibit the action of the esterase and greatly to augment and prolong the action of acetylcholine. These facts have not been applied clinically in the use References 1. Hunt, R., and Taveau, R. de M.: Brit. M. J. 2:1788, 1906.Crossref 2. Dale, H. H.: J. Pharmacol. & Exper. Therap. 6:147, 1914-1915. 3. Guggenheim, M., and Loeffler, W.: Biochem. Ztschr. 74:208, 1916. 4. Feldberg, W., and Rosenfeld, P.: Arch. f. d. ges. Physiol. 232:212, 1933. 5. Dale, H. H., and Feldberg, W.: J. Physiol. 81:320 ( (June 9) ) 1934. 6. Le Heux, J. W.: Arch. f. d. ges. Physiol. 173:8, 1918 7. 179:177, 1920 8. 190:301, 1921. 9. Abderhalden, E., and Pfaffrath, H.: Fermentforsch. 8:284 and 294, 1925. 10. Kühlewein, M.: Arch. f. d. ges. Physiol. 191:99, 1921. 11. Arai, K.: Arch. f. exper. Path. u. Pharmakol. 94:149, 1922. 12. Carlson, A. J.; Smith, E., and Sibbins, I.: Am. J. Physiol. 81:435, 1927. 13. Kahlson, G.: Klin. Wchnschr. 12:1015, 1933. 14. Klee and Grossman: München. med. Wchnschr. 18:581, 1923. 15. Spatz, H., and Wichmann, E.: München. med. Wchnschr. 41:1425, 1924. 16. Wolff, C. G. H., and Canney, J. R.: Lancet 1:707, 1926. 17. Abel, A. L.: Lancet 2:1247, 1933. 18. Fröhner, E.: Toxicologie für Tierärzte , Stuttgart, Ferdinand Enke, 1900. 19. Cushny, A. R.: A Text-Book of Pharmacology and Therapeutics or the Action of Drugs in Health and Disease , ed. 10, Philadelphia, Lea & Febiger, 1934. 20. Cannon, W. B., and Murphy, F. T.: Physiologic Observations on Experimentally Produced Ileus , J. A. M. A. 49:840 ( (Sept. 7) ) 1907. 21. Ochsner, A.; Gage, I. M., and Cutting, R. A.: Value of Drugs in Relief of Ileus , Arch. Surg. 21:924 (Dec., (pt. 1) ) 1930. 22. Fuehner, H.: Arch. f. exper. Path. u. Pharmakol. 82:51 and 205, 1918. 23. Hunt, R.: Am. J. Physiol. 45:231, 1918. 24. Matthes, K.: J. Physiol. 70:338, 1930. 25. Loewi, O., and Engelhart, E.: Arch. f. exper. Path. u. Pharmakol. 150:1, 1930.Crossref 26. Carmichael, E. A., and Fraser, A. R.: Heart 16:263, 1933. 27. Comroe, J. H., and Starr, I.: J. Pharmacol. & Exper. Therap. 49:283, 1933. 28. Simonart, A.: J. Pharmacol. & Exper. Therap. 46:157, 1932. 29. Abbott, W. O.: Am. J. M. Sc. 186:323, 1933. 30. Hoffmann-La Roche supplied the acetylcholine and Merck & Co. supplied the acetyl-beta-methylcholine used in this work. 31. Frank, R.; Zimmerman, L. M., and Necheles, H.: Proc. Soc. Exper. Biol. & Med. 32:686, 1935. 32. J. Pharmacol. & Exper. Therap. 44:235, 1932
Archives of Surgery – American Medical Association
Published: Aug 1, 1936
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