COLIC. 619 



stances. "We may well compare these pains to those that result when 

 a sinapism is applied to the skin, and which disappear as soon as the 

 sinapism is removed. Perhaps some cases of colica verminosa also be- 

 long here, particularly of those where the attacks of pain are followed 

 by the discharge of large mucous masses so-called worm-nests. In 

 the painful and long-continued attacks of colic occurring after ex- 

 posure of the skin, particularly that of the feet and abdomen, to cold, 

 the muscular coat of the intestines appears to suffer in the same way 

 as muscles elsewhere do in rheumatic affections ; hence the affection is 

 well-named colica rheumatica. 



SYMPTOMS AND COURSE. Romberg describes neuralgia mesenr 

 terica as follows : " There are attacks of pain spreading from the navel 

 over the abdomen, alternating with intervals of ease. The pain is 

 tearing, cutting, pressing, most frequently twisting, pinching, intro- 

 duced and accompanied by peculiar bearing-down pains. The patient 

 is restless, and seeks relief in changing his position, and in compressing 

 the abdomen ; his hands, feet, and cheeks are cold ; his features are 

 pinched; the wrinkled brows and contracted lips betray his agony. 

 The pulse is small and hard. The skin of the abdomen is tense, 

 whether puffed up or drawn inward. There are often nausea, vomiting, 

 and desire for stool ; sometimes there is also tenesmus. There is usu- 

 ally constipation, but sometimes the bowels are regular, or even too 

 loose. Such an attack may last from a few minutes to several hours, 

 relaxing at intervals. It ceases suddenly, as if cut off short, and there 

 is a feeling of the greatest relief. The course is periodical, but less 

 regularly so than in other neuralgias." 



Lead-colic is almost always preceded by the symptoms of lead- 

 poisoning. The patients are thin and badly nourished, their skin looks 

 dirty and earthy, the gums are dark, almost slate-gray, the teeth them- 

 selves discolored, and the breath bad ; the patients have a sweetish, 

 metallic taste in the mouth. Then there are periodical pains, which 

 are at first dull, and extend from the epigastrium toward the back and 

 extremities. The pain soon becomes more severe, so that, during the 

 attack, the patients moan and groan, toss themselves about on the bed, 

 or else leave the bed in despair, and do the most foolish things. At 

 the same time, the pulse becomes much slower, the voice is lost, and 

 strangury, nausea and vomiting often occur, showing that the abnormal 

 excitement of the intestinal nerves has spread to other nerves. There 

 is almost always obstinate constipation, and, in spite of the most pow- 

 erful drastics, eight to fourteen days may pass before the evacuation 

 of a small amount of dry, hard, spherical faeces. The abdominal walls 

 are in a very peculiar state ; they are strongly contracted, and the 

 belly seems as hard as a board, and is drawn in. With few excep 



