578 AFFECTIONS OF THE INTESTINAL CANAL. 



Fomica, or nut-galls, Hademacher and his followers consider it as a 

 proof of the dependence of the disease on a primary affection of the or- 

 gans in question, hi spite of the fact that none of these remedies have 

 been proved to have any specific action on these organs whose diseases 

 they are said to cure. The recognition of chronic catarrh with obstruc- 

 tion is facilitated, if there be at the same time a chronic gastric catarrh ; 

 but there are cases where the gastric digestion is intact. In the latter 

 cases, the good appetite, the comfort of the patient after eating, and the 

 clean tongue, readily mislead us into seeking the cause of the trouble 

 in other anomalies than hi disturbances of digestion. If there be also 

 pain hi one or more circumscribed spots in the right hypochondrium, it 

 is often difficult for the physician to make his patient believe that there 

 is chronic intestinal disease. Just at the first flexure of the colon are 

 most frequently found adhesions with the liver, which induce distor- 

 tions and constrictions, and hence sensitiveness to pressure in this 

 region rather confirms than opposes the diagnosis of chronic intestinal 

 catarrh. The diagnosis of this form of chronic catarrh is materially 

 assisted by the symptoms growing worse if the patient remain consti- 

 pated for some time. We shall hereafter have frequent occasion to 

 speak of the diagnosis of chronic intestinal catarrh from other abdom- 

 inal diseases, and will therefore simply again call attention to the fact 

 that it is a very frequent disease, and that hi making a diagnosis we 

 should accustom ourselves to first think of ordinary every-day diseases. 

 If this were more commonly done, there would be fewer of those pa- 

 tients who now say that no physician could aid them, and that they 

 did not improve till they began to take Morrison's pills. 



PROGNOSIS. The prognosis of intestinal catarrh may be deduced, 

 for the most part, from what we have said of its course. An acute 

 case, causing copious transudation and accelerated movements of the 

 intestines, is usually of not much importance or danger ; the diarrhoea 

 may even prove advantageous, by removing irritant substances that 

 have reached the intestines. Moderate intestinal catarrh may also 

 prove beneficial at the period of dentition, in children inclined to hy- 

 persemia of the brain and lungs ; but we should disabuse our patients 

 of the belief that all patients must have diarrhoea while cutting the 

 teeth, and that at this tune we should never try to arrest a diarrhoea. 

 This superstition is widely prevalent and very dangerous ; this is why 

 the physician is often not sent for till the child is debilitated and 

 emaciated, and hi a very dangerous condition. Under well-timed and 

 suitable treatment even the chronic diarrhoeas of children usually offer 

 a favorable prognosis. In accordance with what we have said of its 

 course, even typhlit J3 and its sequelae do not often endanger life. The 

 prognosis is worst in the follicular ulcers of the large intestine, par- 



