(504 AFFECTIONS OF THE INTESTINAL CANAL. 



TREATMENT. In the treatment of scrofulous diseases of the intes- 

 tinal follHes and mesenteric glands, we should first of all combat 

 the morbid predisposition which excites and maintains them. On this 

 point we may refer to what we have said concerning the prophylaxis 

 and causal treatment of pulmonary consumption, and will only call 

 attention to the important rule, so often neglected, that the patient 

 should be kept in the fresh air as much as possible. When speaking 

 of the treatment of scrofula, we shall treat particularly of the indica- 

 tions for cod-liver oil, acorn-coffee, walnut-leaf-tea, as well as of the 

 use of alkaline springs. Cod-liver oil does not by any means increase 

 the diarrhoea in all cases, so that, when its use is indicated, we may try 

 if it will be borne. In other respects the treatment of scrofulous and 

 intestinal ulcers corresponds with that of chronic intestinal catarrh. 

 If the diarrhoea become exhausting, opium will be indispensable, but, 

 before employing this remedy, we should try the astringents and bit- 

 ters recommended for the treatment of catarrhal diarrhoea. If the 

 abdomen become sensitive to pressure, we may use warm poultices. 

 If the pains increase greatly, we may apply a few leeches to the pain- 

 ful part. 



CHAPTER V. 



CARCINOMA OF THE INTESTINES. 



ETIOLOGY. Cancer of the intestines is far rarer than that of the 

 stomach ; it is almost always primary, and is even generally isolated ; 

 it is only in solitary cases that the cancer advances from neighboring 

 organs to the intestine. The etiology is perfectly obscure. 



ANATOMICAL APPEARANCES. Cancer of the intestines affects the 

 large intestines almost exclusively, and particularly the sigmoid flexure 

 and the rectum. Only in rare cases do we find numerous cancerous 

 nodules affecting both the large and small intestine ; in the latter case 

 they correspond to Peyefs glands. 



As in the stomach, so in the intestine, we have scirrhus, medullary 

 and alveolar or colloid cancer. We also find the same combinations of 

 different forms of cancer ; the degeneration often begins in the submu- 

 cous connective tissue as scirrhus, and, after it has perforated the mu- 

 cous membrane, medullary masses arise from the scirrhus base. Cancer 

 of the intestine has a great inclination to spread in the transverse di- 

 rection, and BO form ring-like strictures. The diseased portion of in- 

 testine often sinks down in the abdomen from its weight ; at first it 

 remains movable, but subsequently usually becomes fixed by adhesions 

 between it and neighboring organs, caused by partial peritonitis, 01 



