Effects of Morphine on the Motility of the Human Ileum

Abstract

The opportunities for direct study of intestinal peristalsis in the living human are necessarily limited. The usual methods of investigation have consisted of radiographic procedures or of the introduction of various mechanisms into the bowel, the very presence of which in the bowel may create abnormal reactions. Advantage was taken of a case of intestinal prolapse or bowel externalization (involving lower portion of the ileum) in an otherwise healthy male to record daily the activity of circular and longitudinal muscle. The loop of bowel was approximately 12 inches in length with an artificial anus at its summit so that the lower limb of the loop was constantly empty.

The method of recording described by Alvarez 1 was adapted in the following manner: Two Wiggers myocardiographs were fastened to permanent non-absorbable sutures loosely encircling a common mass of circular or longitudinal muscle. Lines joining points of attachment of the myographs to either circular or longitudinal muscle crossed each other at their mid-points. Attachment was made to the loop of bowel being traversed by intestinal contents. The apparatus was so arranged that it could be set up in working order without altering the position of the patient and might be used with the patient in a lying or semi-sitting position. While conducting the experiments, the bowel was kept covered with normal saline, and kept warm by a 75 Watt drop light. A thin rubber dam was placed over all to prevent evaporation.

The following precautions were observed in all experiments: The patient was prepared in no way for the experiment with the exception that any medication he might have been taking was discontinued the night before. To obviate reactions to the mechanical stimulus, tracings were not taken until at least 20 minutes after the hook-up.