596 AFFECTIONS OF THE INTESTINAL CANAL. 



small children, in whom the disease occurs, proportionately, very often, 

 (In these cases the ccecum and ascending colon are almost always in- 

 verted into the lower part of the large intestine, and into the rectum ; 

 the constipation is not always absolute ; vomiting rarely becomes fecal, 

 and the puffing up of the abdomen is usually moderate as peritonitis 

 is rare. On the other hand, the bloody or bloody-mucous dejections 

 are rarely absent.) The diagnosis of intussusception is beyond doubt, 

 when, from the rectum, we can feel the slit-shaped mouth of the in- 

 vaginated portion of intestine, which is usually turned toward the wall 

 of the rectum, or, if this sloughs off, and is evacuated, somewhat mor- 

 tified, but still recognizable. Obstruction of the bowels by hard fecal 

 masses is readily recognized when these can be felt in the rectum. In 

 other cases, a hard movable tumor in the abdomen leaves little doubt 

 that it is formed of hard fecal masses or stony concretions, and that 

 these obstruct the intestines. If the patient has previously suffered 

 from the symptoms of constriction of the intestines, and if these have 

 suddenly increased to those of absolute obstruction, according to what 

 was above said, it is probable that the sudden obstruction has been in- 

 duced by hard masses of faeces. Above all, the favorable course of the 

 disease, the sudden disappearance of the symptoms after the passages 

 of a quantity of fasces, speaks in favor of the latter variety of ob- 

 struction. 



The diagnosis and prognosis of obstruction of the intestine are 

 evident from what we have said of the symptoms and course of the 

 disease. 



TREATMENT. The treatment of habitual constipation has been as 

 fully discussed as the plan of this work allows, when speaking of the 

 causal indications hi the previous chapter ; a discussion of the advan- 

 tages of and objections to individual laxatives does not come within 

 its scope. I have no personal experience of the result of the Swedish 

 movement-cure in habitual constipation. Electricity, which has also 

 been recommended, comes under the head of gymnastics ; contractions 

 of the abdominal muscles may be caused by applying the electrodes 

 to the skin of the abdomen, and they may be strengthened by repeated 

 applications. Application of the electrodes to the abdomen has no 

 effect on the movements of the intestines themselves. The proposal 

 to place one electrode in the mouth, the other in the anus, must be 

 regarded as very naive. 



If stricture of the intestine be located in the rectum, the treatment 

 consists in the removal of tumors, or dilatation of strictures, and, where 

 these procedures will not answer, in the formation of an artificial anus ; 

 hence it belongs to surgery. Contractions of the intestine higher up 

 can never be radically cured. We have to limit ourselves to placing 



