678 ENTERITIS. 



membrane we find somewhat similar changes in the gland- 

 structures scattered over the bowel, with, in course of time, 

 particular changes further developed in connection with the 

 gland-structures from condensation and alteration of the con- 

 nective-tissue amongst which they are placed. In some we 

 have distinctly atrophic changes, lessening of the general bulk 

 of the mucous membrane, with shrinking or disappearance of 

 the gland-structures proper. 



Symptoms. — In common with simple functional disturbance 

 of the bowels, known by the generic name of colic, the more 

 serious structural lesions accompanying the peculiar conges- 

 tions and inflammations which there take place are chiefly 

 made known to us by the exhibition of those symptoms which 

 are indicative of abdominal pain. Like simple disturbance 

 of functional activity, inflammatory action, although usually 

 said to be developed suddenly, will, if observation has been 

 carefully exercised, be frequently found to have had a more 

 gradual development. 



In differentiating the symptoms of these two conditions 

 much care is needed, and, even after such has been exercised, 

 much uncertainty remains. 



The character of the pain does not, judging from the modus 

 of its manifestation, seem to differ in either. In ordinary 

 functional disturbance it may even seem more severe ; it may,, 

 however, in enteritis, as distinct from merely derangement of 

 the canal, be regarded as being more steadily continuous, 

 rarely having intervals of remission. In particular instances 

 of enteric inflammations manipulation or pressure over the 

 abdomen is not tolerated, but rather tends to aggravate the 

 distress. The pulse, which in simple disorder of the bowels is 

 unaltered, save during paroxysms of pain, when it is variously 

 affected both as to character and frequency, is, in the more 

 serious textural changes, steadily progressive in disturb- 

 ance. 



At first merely increased in frequency, it gradually, in the 

 earlier stages, acquires a character of tension or resistance, the 

 volume not perceptibly altered, with no return to its normal 

 characters ; in the latter stages we have increased frequency 

 with lessened volume but marked resistance, passing on tO' 

 feebleness of impulse Avitli rapid and weak cardiac action. 



