Читать книгу A Handbook of Health - Woods Hutchinson - Страница 12

The Flow of Saliva and "Appetite Juice." We are now ready to start some food-fuel, say a piece of bread, on its journey down our food tube, or alimentary canal. One would naturally suppose that the process of digestion would not begin until the food got well between our teeth; but, as a matter of fact, it begins before it enters our lips, or even before it leaves the table. If bread be toasted or freshly baked, the mere smell of it will start our mouths to watering; nay, even the mere sight of food, as in a pastry cook's window, with the glass between us and it, will start up this preparation for the feast.

This flow of saliva in the mouth is of great assistance in moistening the bread while we are chewing it; but it goes farther than this. Some of the saliva is swallowed before we begin to eat; and this goes down into the stomach and brings word to the juices there to be ready, for something is coming. As the food approaches the mouth, a message also is telegraphed down the nerves to the stomach, which at once actively sets to work pouring out a digestive juice in readiness, called the "appetite juice." This shows how important are, not merely a good appetite, but also attractive appearance and flavor in our food; for if this appetite juice is not secreted, the food may lie in the stomach for hours before the proper process of digestion, or melting, begins.

The Salivary Glands. Now, where does this saliva in the mouth come from? It is poured out from the pouches of the cheeks, and from under the tongue, by some little living sponges, or juice factories, known as salivary glands.[2]

THE SALIVARY GLANDS

In this diagram are shown the three glands (G) of the left side. The duct (D) from the parotid gland empties through the lining of the cheek; those from the lower glands empty at the front of the mouth under the tongue (T). N, nerve; A, artery; V, vein.

All the juices poured out by these glands, indeed nearly all the fluids or juices in our bodies, are either acid or alkaline. By acid we mean sour, or sharp, like vinegar, lemon juice, vitriol (sulphuric acid), and carbonic acid (which forms the bubbles in and gives the sharp taste to plain soda-water). By alkaline we mean "soap-like" or flat, like soda, lye, lime, and soaps of all sorts. If you pour an acid and an alkali together—like vinegar and soda—they will "fizz" or effervesce, and at the same time neutralize or "kill" each other.

The Use of the Saliva. As the chief purpose of digestion is to prepare the food so that it will dissolve in water, and then be taken up by the cells lining the food-tube, the saliva, like the rest of the body juices, consists chiefly of water. Nothing is more disagreeable than to try to chew some dry food—like a large, crisp soda cracker, for instance—which takes more moisture than the salivary glands are able to pour out on such short notice. You soon begin to feel as if you would choke unless you could get a drink of water. But it is not altogether advisable to take this short cut to relief, because the salivary juice contains what the drink of water does not—a ferment, or digestive substance (ptyalin), which possesses the power of turning the starch in our food into sugar. As starch is only very slowly soluble, or "meltable," in water, while sugar is very readily so, the saliva is of great assistance in the process of melting, known as digestion. The changing of the starch to sugar is the reason why bread or cracker, after it has been well chewed, begins to taste sweetish.

This change in the mouth, however, is not of such great importance as we at one time thought, because even with careful mastication, a certain amount of starch will be swallowed unchanged. Nature has provided for this by causing another gland farther down the canal, just beyond the stomach, called the pancreas, to pour into the food tube a juice which is far stronger in sugar-making power than the saliva, and this will readily deal with any starch which may have escaped this change in the mouth. Moreover, this "sugaring" of starch goes on in the stomach for twenty to forty minutes after the food has been swallowed.

Starchy foods, like bread, biscuit, crackers, cake, and pastry, are really the only ones which require such thorough and elaborate chewing as we sometimes hear urged. Other kinds of food, like meat and eggs—which contain no starch and consequently are not acted upon by the saliva—need be chewed only sufficiently long and thoroughly to break them up and reduce them to a coarse pulp, so that they can be readily acted upon by the acid juice of the stomach.

Down the Gullet. When the food has been thoroughly moistened and crushed in the mouth and rolled into a lump, or bolus, at the back of the tongue, it is started down the elevator shaft which we call the gullet, or esophagus. It does not fall of its own weight, like coal down a chute, but each separate swallow is carried down the whole nine inches of the gullet by a wave of muscular action. So powerful and closely applied is this muscular pressure that jugglers can train themselves, with practice, to swallow standing on their heads and even to drink a glass of water in that position; while a horse or a cow always drinks "up-hill." This driving power of the food tube extends throughout its entire length; it is carried out by a series of circular rings of muscles, which are bound together by other threads of muscle running lengthwise, together forming the so-called muscular coat of the tube. By contracting, or squeezing down in rapid succession, one after another, they move the food along through the tube. The failure of these little muscles to act properly is one of the causes of constipation and biliousness. Sometimes the action of the muscles is reversed, and then we get a gush of acid, or bitter, half-digested food up into the mouth, which we call "heart-burn" or "water-brash."

The Stomach—its Shape, Position, and Size. By means of muscular contraction, then, the gullet-elevator carries the food into the stomach. This is a comparatively simple affair, merely a ballooning out, or swelling, of the food tube, like the bulb of a syringe, making a pouch, where the food can be stored between meals, and where it can undergo a certain kind of melting or dissolving. This pouch is about the shape of a pear, with its larger end upward and pointing to the left, and its smaller end tapering down into the intestine, or bowel, on the right, just under the liver. The middle part of the stomach lies almost directly under what we call the "pit of the stomach," though far the larger part of it lies above and to the left of this point, going right up under the ribs until it almost touches the heart, the diaphragm only coming between.[3] This is one of the reasons why, when we have an attack of indigestion, and the stomach is distended with gas, we are quite likely to have palpitation and shortness of breath as well, because the gas-swollen left end of the stomach is pressing upward against the diaphragm and thus upon the heart and the lungs. Most cases of imagined heart trouble are really due to indigestion.

The Lining Surface of the Stomach. Now let us look more carefully at the lining surface of the stomach, for it is very wonderful. Like all other living surfaces, it consists of tiny, living units, or "body bricks" called cells, packed closely side by side like bricks in a pavement. We speak of the mucous membrane, or lining, of our food tube, as if it were one continuous sheet, like a piece of calico or silk; but we must never forget that it is made up of living ranks of millions of tiny cells standing shoulder to shoulder.

These cells are always actively at work picking out the substances they need, and manufacturing out of them the ferments and acids, or alkalies, needed for acting upon the food in their particular part of the tube, whether it be the mouth, the stomach, or the small intestine.

A SECTION OF THE LINING SURFACE OF THE STOMACH

(Greatly magnified)

Showing the mouths of the stomach glands, and the furrows, or folds, of the lining.

The Peptic Juice. The cells of the stomach glands manufacture and pour out a slightly sour, or acid, juice containing a ferment called pepsin. The acid, which is known as hydrochloric acid, and the pepsin together are able to melt down pieces of meat, egg, or curds of milk, and dissolve them into a clear, jelly-like fluid, or thin soup, which can readily be absorbed by the cells lining the intestine.[4]

You can see now why you shouldn't take large doses of soda or other alkalies, just because you feel a little uncomfortable after eating. They will make your stomach less acid and perhaps relieve the discomfort, but they stop or slow down digestion. Neither is it well to swallow large quantities of ice-water, or other very cold drinks, at meal times, or during the process of digestion. As digestion is largely getting the food dissolved in water, the drinking of moderate quantities of water, or other fluids, at meals is not only no hindrance, but rather a help in the process. The danger comes only when the drink is taken so cold as to check digestion, or when it is used to wash down the food in chunks, before it has been properly ground by the teeth.

Digestion in the Stomach. Although usually a single, pear-shaped pouch, the stomach, during digestion, is practically divided into two parts by the shortening, or closing down, of a ring of circular muscle fibres about four inches from the lower end, throwing it into a large, rounded pouch on the left, and a small, cone-shaped one on the right. The gullet, of course, opens into the large left-hand pouch; and here the food is stored as it is swallowed until it has become sufficiently melted and acidified (mixed with acid juice) to be ready to pass on into the smaller pouch. Here more acid juice is poured out into it, and it is churned by the muscles in the walls of the stomach until it is changed to a jelly-like substance.

A LONGITUDINAL SECTION OF STOMACH, OR PEPTIC, GLANDS

(Greatly magnified)

The long duct of each gland is but a deep fold of the stomach lining (see note, p. 11). Into this duct the ranks of cells around it pour out the peptic juice.

Digestion in the Small Intestine. The food-pulp now passes on into the small intestine, where it is acted upon by two other digestive juices—the bile, which comes from the liver, and the pancreatic juice, which is secreted by the pancreas.

The liver and the pancreas are a pair of large glands which have budded out, one on each side of the food tube, about six inches below where the food enters the small intestine from the stomach. The liver[5] weighs nearly three pounds, and the pancreas about a quarter of a pound.

Of these two glands, the pancreas, though the smaller, is far more important in digestion. In fact, it is the most powerful digestive gland in the body. Its juice, the pancreatic juice, can do everything that any other digestive juice can, and do it better. It contains a ferment for turning starch into sugar, which is far more powerful than that of the saliva; also another (trypsin), which will dissolve meat-stuffs nearly twice as fast as the pepsin of the stomach can; and still another, not possessed by either mouth or stomach glands, which will melt fat, so that it can be sucked up by the lining cells of the intestine.

What does this great combination of powers in the pancreas mean? It means that we have now reached the real centre and chief seat of digestion, namely, the small intestine, or upper bowel. This is where the food is really absorbed, taken up into the blood, and distributed to the body. All changes before this have been merely preparatory; all after it are simply a picking up of the pieces that remain.

In general appearance, this division of the food tube is very simple—merely a tube about twenty feet long and an inch in diameter, thrown into coils, so as to pack into small space, and slung up to the backbone by broad loops of a delicate tissue (mesentery). It looks not unlike twenty feet of pink garden hose.

The intestine also is provided with glands that pour out a juice known as the intestinal juice, which, although not very active in digestion, helps to melt down still further some of the sugars, and helps to prevent putrefaction, or decay, of the food from the bacteria[6] which swarm in this part of the tube.

By the time the food has gone a third of the way down the small intestine, a good share of the starches in it have been turned into sugar and absorbed by the blood vessels in its wall; and the meats, milk, eggs, and similar foods have been digested in the same way.

There still remains the bulk of the fats to be disposed of. These fats are attacked by the pancreatic juice and the bile, and made ready for digestion. Like other foods, they are then eaten by the cells of the intestinal wall; but instead of going directly into the blood vessels, as the sugars and other food substances do, they are passed on into another set of little tubes or vessels, called the lymphatics. In these they are carried through the lymph glands of the abdomen into the great lymph duct, which finally pours them into one of the great veins not far from the heart. Tiny, branching lymphatic tubes are found all over the body, picking up what the cells leave of the fluid which has seeped out of the arteries for their use and returning it to the veins through the great lymph duct.

All these different food substances, in the process of digestion, do not simply soak through the lining cells of the food tube, as through a blotting paper or straining cloth, but are actually eaten by the cells and very much changed in the process, and are then passed through the other side of the cells, either into the blood vessels of the wall of the intestine or into the lymph vessels, practically ready for use by the living tissues of the body. It is in the cells then that our food is turned into blood, and it is there that what we have eaten becomes really a part of us. It may even be said that we are living upon the leavings of the little cell citizens that line our food tube; but they are wonderfully decent, devoted little comrades of the rest of our body cells, and generous in the amount of food they pass on to the blood vessels.

As the food-pulp is squeezed on from one coil to another through the intestine, it naturally has more and more of its nourishing matter sucked out of it; until, by the time it reaches the last loop of the twenty feet of the small intestine, it has lost over two-thirds of its food value.

The Final Stage—the Journey through the Large Intestine. From the small intestine what remains of the food-pulp is poured into the last section of the food tube, which enlarges to from two to three inches in diameter. It is known as the large intestine, or large bowel. This section is only about five feet long. The first three-fourths of it is called the colon; the last or lowest quarter, the rectum, the discharge-pipe of the food tube. The principal use of the colon is to suck out the remaining traces of nourishing matter from the food and the water in which it is dissolved, thus gradually drying the food-pulp down to a solid or pasty form, in which condition it collects in a large "S" shaped loop of the bowel just above the rectum, until discharged.

The Waste Materials. By the time that the remains of the food-pulp have reached the middle of the large intestine, they have lost all their nutritive value and most of their water. All the way down from the upper part of the small intestine they have been receiving solid waste substances poured out by the glands of the intestines; indeed, the bulk of the feces is made up of these intestinal secretions, not, as is generally supposed, of the undigested remains of the food. Ninety-five per cent of our food is absorbed; the body-engine burns up its fuel very clean. The next largest part of the feces is bacteria, or germs; and the third and smallest, the indigestible fragments and remainders of food, such as vegetable fibres, bran, fruit skins, pits, seeds, etc. Hence the feces are not only worthless from a food point of view, but full of all sorts of possibilities for harm; and the principal interest of the body lies in getting rid of them as promptly and regularly as possible.

It can easily be seen how important it is that a habit should be formed, which nothing should be allowed to break, of promptly and regularly getting rid of these waste materials. For most persons, once in twenty-four hours is normal; for some, twice or even three times in the day. Whatever interval is natural, it should be attended to, beginning at a fixed hour every morning.

Constipation, and how to Prevent It. Constipation should not be treated by the all too common method of swallowing salts, which will cause a flood of watery matters to be poured through the food tube and sluice it clean of both poisons and melting food at the same time, leaving it in an exhausted and disturbed condition afterwards; nor by taking some irritating vegetable cathartic, generally in the form of pills, which sets up a violent action of the muscles of the food tube, driving its contents through at headlong speed; nor by washing out the lower two or three feet of the bowel with injections of water; although any or all of these may be resorted to occasionally for temporary relief. A very large portion of the food eaten is sucked out of the food tube into the blood vessels, passes through a large area of the body, and is poured out again as waste through the glands of the lining of the lower third of the bowel. Constipation, therefore, is caused by disturbances which interfere with these processes all over the body, not only in the stomach and bowels. Its only real and permanent cure is through exercise in the open air, sleep, and proper ventilation of bedrooms, with abundance of nourishing food, including plenty of green vegetables and fresh fruits.

The Appendix and Appendicitis. The beginning of the large bowel, where the small bowel empties into it, is the largest part of it, and forms a curious pouch called the cecum, or "blind" pouch. From one side of this projects a little wormlike tube, twisted and coiled upon itself, from three to six inches long and of about the size of a slate pencil. This is the famous appendix vermiformis (meaning, "wormlike tag"), which is such a frequent source of trouble. It is the shrunken and shriveled remains of a large pouch of the intestine which once opened into the cecum, and was used originally as a sort of second stomach for delaying and digesting the remains of the food. The reason why it gives rise to so much trouble is that it is so small—scarcely larger than will admit a knitting-needle—and so twisted upon itself that germs or other poisonous substances swallowed with the food may get into it, start a swelling or inflammation, get trapped in there by the closing of the narrow mouth of the tube, and form an abscess, which leaks through, or bursts into, the cavity of the body, called the peritoneum. This causes a very serious and often fatal blood poisoning.

Fortunately, appendicitis, or inflammation of the appendix, is not a very common disease, causing only one in one hundred of all deaths that occur; and these are mostly cases that were not treated promptly. Yet, if you have a severe, constant pain, rather low down in the right-hand corner of your abdomen, and if, when you press your hand firmly down in that corner, it hurts, or you feel a lump, it is decidedly safest to call a doctor and let him see what the condition really is, and advise you what to do.