440 DISEASES OF DIGESTION. 



SYMPTOMS. — There is no characteristic symptom by which we 

 can tell the presence of a calculus in the digestive canal ; although 

 there are several which are common to the disturbance brought 

 about by it, and to other disorders. The only certain means — • 

 which is not always within our poAver to put in practice — by 

 which we can determine the existence of such a body in the 

 abdomen, is feeling it, which we can generally best do by intro- 

 ducing the hand into the rectum. These balls may attain a large 

 size without causing death, or even without giving rise to any 

 marked symptoms of ill-health, in which case we may infer that 

 they continue to remain in some portion of the intestine, where, 

 owing to the large diameter of the gut, or to the fact of their 

 having made for themselves a pocket in it, they do not cause 

 obstruction to the passage of food, until they become greatly in- 

 creased in bulk. If, however, they happen to become dislodged, 

 as for instance, by the action of a purgative, they may, very pos- 

 sibly, set up fatal obstruction by becoming wedged in some nar- 

 rower portion of the large intestine, which varies greatly in size 

 along its com'se. It appears that calculi cause colic far more 

 frequently by the fact of their shifting, than by their being large. 

 The ordinary (though by no means characteristic) symptoms of the 

 presence of calculus are : frequent attacks of colic from no other 

 ostensible cause; pawing with the fore feet from evident ab- 

 dominal trouble ; resting the hind quarters against some support, 

 as a wall, for instance; and sitting on the haunches like a dog. 

 Dick remarks that : " in an advanced stage, no doubt can re- 

 main as to the nature of the disorder. The countenance is hag- 

 gard, the eye distressed, the back up, the belly distended, the 

 respiration becomes hurried, bowels habitually costive." The 

 habit of seeking relief by resting the hind quarters against some 

 support, is also seen in impaction of the bowels by undigested food. 

 Often in fatal cases, there is continued pain for two or three weeks, 

 or even more, before death. 



TREATMENT. — If the presence of a calculus be suspected, the 

 arm should be passed into the rectum with the object of removing 

 any of these balls which may be in reach. Dick recommends 

 giving strong purgatives and large enemas with the view of clearing 

 away the obstruction. Although a strong purgative might hasten 

 death by dislodging a calculus which had, up to the time being, 

 caused no inconvenience; the fact remains that it often brings 

 away calculi, the presence of which in the intestines had been 

 unsuspected. 



