INTESTINAL CATARRH. 581 



habitual constipation, I have, nevertheless, been agreeably surprised 

 by its decided effect in many cases of this affection. Some patients 

 have assured me that, from the time they began to take the belladonna 

 pills, they had felt like new beings, and, particularly with the last pre- 

 scription, they had less disagreeable sensations than with the former 

 ones. Unfortunately, I cannot at present distinguish the cases of 

 habitual constipation where belladonna is indicated from those where 

 it is not. It is to be hoped that future observations will determine the 

 cases proper for the use of this remedy, which is so excellent in some 

 forms of habitual constipation. 



In typhlitis stercoralis, the causal indications also require the re- 

 moval of the masses collected in the caecum and ascending colon, it is 

 true, but this is to be done with care. If the case be recent, and un- 

 accompanied by vomiting, we may give a full dose of castor-oil ( ss 

 j), but if vomiting has begun, and the oil administered be rejected, 

 we should cease the attempt of giving internal remedies to cause a 

 passage, and, above all, we should not be led into the error of giving 

 drastic purges. As long as there is an insuperable obstacle to the 

 passage downward of the contents of the intestines, all remedies that 

 increase the movements of the bowels cause then: contents to move 

 upward, and induce vomiting. In the latter cases, the clysopompe 

 [Davidson's syringe] is an invaluable remedy; it cannot be replaced 

 by a simple syringe, even if we give several injections in succession. 

 We may inject as much as four pints of liquid ; as pure water is readily 

 absorbed in the large intestine, we should add to it salt, oil, milk, or 

 honey. Vomiting usually ceases after a moderate evacuation, or even 

 when the passage of a few badly-smelling, crumbly masses shows that 

 the fluid has reached the fecal collections, and has softened and set 

 them in motion. But if there has been a free evacuation, we must not 

 be misled, by the swelling in the csecal region, into continuing the 

 evacuant treatment. If the intestinal wall or the peritonaeum be ex 

 tensively inflamed, we shall increase the pain and inflammation by con 

 tinuing to excite the movements of the intestines. 



The indications from the disease never require bleeding in acute 

 intestinal catarrh, and even leeching may be dispensed with, except in 

 the treatment of typhlitis. But, in the latter disease, the application 

 of 10 20 leeches in the right iliac region, and the employment of 

 cataplasms, to keep up the bleeding, are usually very beneficial, and 

 the operation should be repeated if the pains recur. As we mentioned 

 when speaking of cholera morbus, cold suits those cases where the 

 hyperaemia is excessive, and is accompanied by moderate transudation 

 into the intestine, as well as in the severe forms of catarrhal enteritis, 

 which occur after extensive burns, and are accompanied by gieat pain. 



