330 INFLAMMATION OF THE INTESTINES. 



the passage of some thin glairy matter, which shows that 

 no obstruction exists : on the contrary, when these are pre- 

 sent, a most obstinate costiveness may yet remain farther 

 up in the canal; and a flow of thin fseces may escape bv 

 a groove formed by the side of the obstructing portion Jf 

 dung, as has happened when very large feecal accumulation 

 has taken place within one of the pouches of the colon 

 Unless there be evidently a free passage throughout the 

 whole canal, it is always proper to back-rake ; for it must 

 not be lost sight of, that costiveness in true enteritis is 

 always present, and when not its cause, is always its most 

 aggravating symptom ; and until it be removed, a resolution 

 of the inflammation cannot take place. It is also necessary 

 to bear in mind, that the state of the bowels being such as 

 not to render it prudent to give strong purgatives, the 

 case IS beset with difficulties. Injections of thin gruel 

 or of warm water, may be afterwards occasionally exhibited' 

 Ihe quantities composing the clysters should be very con- 

 siderable, so as to penetrate beyond the rectum, and to enter 

 It possible, the colon and caecum, which intention can be 

 best fulfilled by the injecting syringe. Tobacco clysters 

 liave likewise proved beneficial. 



_ The next indication is to raise a brisk external inflamma- 

 tion over the belly, to lessen thereby the internal affection • 

 and in this case the cantharides are not quick enough in 

 their action : but a more speedy determination to the skin 

 may be gained by applying— firstly, a cloth saturated with 

 hquor ammonia, diluted by four times its amount of water 

 and retaining it in its situation by means of a blanket several 

 times doubled, and held by four men with not very fasti- 

 dious noses. This form of blister, however, requires to be 

 constantly watched, as else it may dissolve the skin After 

 wards a fresh sheep skin may be laid upon the back and 

 Joins. With regard to medicine by the mouth, in the first 

 place give three ounces of solution of aloes, and an ounce of 

 extract of gentian, with a pint of cold water. At the same 

 time admmister half a drachm of calomel, with a drachm of 

 opium, made into a ball with linseed meal and treacle 

 Ihe ball may be repeated every hour, till the symptoms 

 abate, when the calomel may be diminished to a scruple • and 

 shortly afterwards given at wider intervals, till it is gradually 



