582 AFFECTIONS OF THE INTESTINAL CANAL 



The best mode of using cold is by applying cloths, wrung out of cold 

 water, to the abdomen. In the chronic forms of intestinal catarrh, par- 

 ticularly those combined with obstruction, irritating and warming com- 

 presses are suitable ; among these, Preissnitz's compress is extensively 

 used. We let the patient wear a wet towel, covered with a dry one, 

 during the night only, or renew it several times daily. In those cases 

 of chronic intestinal catarrh accompanied by the production of tough 

 mucus, the same mineral waters are indicated as in the analogous form 

 of gastric catarrh. The astringents, also, particularly nitrate of silver 

 and tannin, may, by their astringent action, moderate the relaxation 

 of the mucous membrane, decrease the hyperasmia, and so answer the 

 indications from the disease. Besides these remedies, of which nitrate 

 of silver, in small doses, particularly deserves trial in the chronic ca- 

 tarrh of young children, we may use catechu, kino, Colombo, casca- 

 rilla, etc. ; but the circumstances where any particular one of these 

 remedies deserves the preference are still obscure, and we employ one 

 when we find another unserviceable. Employment of astringents, in 

 the form of enemata, is only advisable when the catarrh affects the 

 large intestine, as even large enemata will not pass the ileo-caecal 

 valve and enter the small intestine. In follicular ulcers, which par- 

 ticularly occur in the lower part of the large intestine, enemata of 

 nitrate of silver (gr. ij vj to f vj), sulphate of zinc, or tannin ( 3 ss 

 to i vj), are very useful, and are preferable to all other remedies, but, 

 unfortunately, they are not well borne in all cases. 



In cases where the diarrhoea is to be regarded as au injurious, 

 rather than as a favorable symptom, the indications are to arrest it. 

 It is easy to tell, in each case, when the time has come for arresting 

 the discharges. No general rules for this can be given. We usually 

 first attempt to attain our end by dietetic rules, by prescribing mucila- 

 ginous drinks, oat-meal, rice, or barley-water, or give soups made of 

 parched meal ; and these prescriptions are worth trying. I will not dis- 

 cuss the question as to whether mutton-broth, particularly when fat, will 

 cure diarrhoea, as is popularly believed. Besides mucilaginous drinks, 

 slightly astringent liquids, which are not exactly medicines, are usually 

 prescribed ; red wine, infusions of dried whortleberries, roasted acorns, 

 etc. These also may prove serviceable, and are worthy of trial in slight 

 cases. The astringents mentioned above, when speaking of the indi- 

 cations from the disease, may also be named among diarrhoea remedies. 

 As we have already said, nitrate of silver is particularly serviceable in 

 the chronic diarrhoea of children, while catechu in large doses ( 3 ij to 

 vj of mucilage, a tablespoonful every hour or two) is often surprising- 

 ly efficacious in the diarrhoea of adults. In proportion to the advantage 

 from its use, acetate of lead is too dangerous a remedy to merit extcn- 





