INTESTINAL CATARRH. 569 



serous transudation, there is acceleration of the movements of the in- 

 testines, so that the passages are not only more fluid, but they become 

 more frequent. Diarrhoea, which is often preceded by rumbling in the 

 intestines, is the most constant, and occasionally the only symptom of 

 acute intestinal catarrh. Pain and other symptoms may be absent, 

 the strength and nutrition of the patient may remain normal, if the 

 evacuations be not too copious and long continued. In such cases the 

 laity usually regard the diarrhoea as a favorable symptom, from which 

 they anticipate a cleansing of the body and all sorts of benefit. At 

 first the evacuations consist of thin fecal matters (diarrhoea stercoralis). 

 If the serous transudation and the accelerated peristaltic movement 

 continue after all the fasces present in the bowels have been evacuated, 

 the dejections gradually lose the peculiar fecal odor, and consist of 

 salty transudations mixed with epithelial masses (cylindrical epithe- 

 lium), young cells, and more or less undigested and slightly-changed 

 ingesta (diarrhoea serosa). The color of fluid stools is usually some 

 shade of green ; this does not depend on an abnormal quantity of bile 

 being poured into the intestines, but on the bile being evacuated with 

 the fluid and the intestinal secretions, before it has undergone the 

 normal changes. The more copious the transudations, the paler they 

 become, because the bile, mixed with them, is insufficient to color the 

 whole. There is scarcely a trace of albumen in these catarrhal evacua- 

 tions ; but there are not unfrequently crystals of phosphate of mag 

 nesia and ammonia, whose presence was long considered as character- 

 istic of typhous passages, and there is usually plenty of chloride of 

 sodium. Generally, after the diarrhoea has lasted a day or two, or 

 even longer, the normal transformations of the ingesta begin again ; 

 the evacuations become less frequent, and again acquire then* feculent 

 appearance and smell. A more or less obstinate constipation gener- 

 ally follows the diarrhoea. 



In other cases, besides the diarrhoea, there are pains in the abdomen. 

 These are chiefly periodical attacks of griping pain or colic, during 

 which, if the pain be severe, the patient becomes very pale and cool. 

 These colicky pains usually subside when a discharge from the bowels 

 has just taken place, or is about to occur. A continued feeling of 

 pressure or soreness, and of sensitiveness to pressure, in the abdomen, 

 is seen far more rarely than the above-mentioned attacks of pain. It 

 is only in the rare cases, where acute intestinal catarrh accompanies 

 extensive burns of the skin, that the latter pains become very severe. 

 This peculiarity and the presence of blood in the evacuations distin- 

 guish this form from all others. 



In acute intestinal catarrh the abdomen is often somewhat promi- 

 nent, and quantities of badly-smelling gases escape with the passasrea 



