BLEEDING FROM THE STOMACH. 137 



which it is poured out. When a little blood comes from the upper part of the 

 bowels, and is slowly discharged, it is dark in colour, being sometimes quite black, 

 and presenting a tarry or sooty aspect, so thaty its real nature may not at first sight 

 be suspected. When the blood comes from the lower part of the bowel, near the 

 extremity, it is often quite bright-red, and has undergone very little change. The 

 quantity may vary from a mere streak to half a pint or more. It must be re- 

 membered that many medicines, such as iron and lead, stain the motions black, and 

 this, of course, must not be mistaken for altered blood. Many people get very 

 anxious if they find that their motions are black, but it occurs naturally when taking 

 certain metallic substances. 



The treatment of bleeding from the bowels does not differ essentially from that 

 of bleeding from other parts of the body. In the first place the patient should be 

 made to lie down in a cool room, and should be kept as quiet as possible. Cold wrt 

 compresses should be applied to the abdomen, and if there is any one particular spot 

 where pain or tenderness is experienced, or from which there is reason to suppose 

 the haemorrhage proceeds, a bag or bladder of ice should be applied on that region. 

 Some astringent medicine must be given internally, and one of the best for this 

 purpose is the acetate of lead mixture (Pr. 30), a dose every four hours. Should 

 this not be at hand, perchloride of iron (Pr. 1 or 2) or gallic acid (Pr. 29) may be used. 

 Thirty drops of turpentine taken in milk will often succeed better than anything ; 

 it should be repeated every three hours until the bleeding ceases. A very simple 

 and efficacious plan is to inject ice-cold water into the bowel. In these cases, too, 

 the tincture of hamamelis virginica often succeeds admirably. A drop should be 

 given in a tea-spoonful of water every quarter of an hour for the first hour, and 

 then two drops every second or third hour. It is most likely to do good when the 

 blood is dark in colour. 



The energy with which the treatment should be pursued, and the question as 

 to whether a doctor should be called in or not, must obviously depend on the 

 amount of bleeding. 



BLADDER, DISEASES OF. (See Diseases of Kidney and Bladder.) 



BLEEDING FROM THE STOMACH HJEMATEMESIS. 



Haematemesis, or haemorrhage from the stomach, must be regarded simply as a 

 symptom of disease, and not as a disease itself. It occurs in the course of many 

 morbid conditions of the stomach and other organs. As a primary or idiopathic 

 condition it is practically unknown ; we never meet with bleeding from the stomach 

 analogous to the bleeding from the nose which is of such frequent occurrence in 

 children and young people. 



But haemorrhage from the stomach, occurring in connection with other con- 

 stitutional haemorrhages, or in their stead, is by no means uncommon. Not in- 

 frequently haematemesis is vicarious of menstruation, replacing the periods month 

 after month with the greatest regularity. The case is recorded of a young woman 

 who became the subject of haematemesis recurring at the monthly periods about the 



