570 AFFECTIONS OF THE INTESTINAL CANAL. 



The development of gas in the intestines cannot be regarded as a symp- 

 tom, or as the result of acute intestinal catarrh, as long as this is in 

 the stage of moderate transudation and increased peristaltic motion ; 

 it more frequently depends on the same causes as the catarrh itself, 

 particularly on the passage of undigested and decomposing food from 

 the stomach into the intestines. 



Finally, acute intestinal catarrh is not unfrequently accompanied by 

 fever. If it was caused by catching cold, it generally shows the pecu- 

 liarities of so-called catarrhal fever; in other cases the fever is more 

 severe, and, if the stomach be affected at the same time, we have the 

 symptoms of a gastric, bilious, or catarrhal fever, which we shall here- 

 after describe. 



Acute intestinal catarrh runs the above course when it affects a 

 large portion of the intestines, or if, as is usually the case, it be located 

 hi the lower part of the ileum and colon. Catarrh of the duodenum 

 often accompanies catarrh of the stomach ; but it can only be recog- 

 nized when it extends to the ductus choledochus, and so causes obstruc- 

 tion of the gall-ducts and jaundice ; in all other cases it modifies the 

 symptoms of gastric catarrh too little to be recognized. 



Catarrh of the small intestines may run its course without diar- 

 rhoea, if the fluid contents of the small intestine remain for some time 

 in the large intestine, and become thickened by resorption of the 

 watery portions. If, with the symptoms of gastric catarrh, we have 

 loud gurgling and rumbling in the abdomen, showing that there are 

 gases and liquids moving about in the bowels, but if the anticipated 

 discharge do not occur, we are justified in supposing that the gastric 

 catarrh has extended to the small intestines, but not to the large. 



There is often catarrh of the lower part of the large intestine and 

 of the rectum without coincident disease of the other parts of the 

 intestinal canai. When the inflammation is very severe, and shows a 

 change from the catarrhal to the diphtheritic form, the symptoms are 

 peculiar. Just as hi dysentery, the passages are preceded by severe 

 cutting pains, which spread from the navel toward the sacrum. Then 

 there are spasmodic contractions of the sphincter, burning sensations 

 at the anus, and, with severe pressure and straining, more or less 

 white and glairy mucus, often mixed with blood, is evacuated. After 

 this there is generally relief for a while, when the pains begin again, 

 and the scene is repeated. Occasionally masses of hard faeces are 

 passed, and the patient is left at rest for some time. Under proper 

 treatment, i e., if we immediately remove the hardened faeces, which 

 excite and maintain the disease, catarrhal dysentery (as this disease 

 is properly called) may be quickly cured. Improperly treated, it may 

 be protracted, and lead to follicular ulcerations. 



