INTESTINAL ACTION. 431 



we possess anthelmintic enemata, which remove worms, such 

 as the Enema Terebinthinse, Enema Aloes, and an enema of 

 bitter infusions, or salt and water. Ice-cold water may be 

 injected into the rectum as an antipyretic enema, i.e. to reduce 

 the temperature, and as a styptic enema in haemorrhage. 



III. PATHOLOGICAL KELATIONS. 



As far as our present purpose is concerned, the disturbances 

 of the intestine, independently of its digestive function, which 

 has been already discussed, are chiefly two, namely : excessive 

 action, the striking phenomenon of which is diarrhoea, and 

 defective action, characterised by constipation. 



1. Excessive Intestinal Action. Diarrhoea, as we have seen, 

 is generally referable to gastric or duodenal dyspepsia. The 

 ultimate cause is most commonly improper food, including the 

 various irritant substances which may be admitted along with 

 it, such as unwholesome drinks, the organisms of putrefaction, 

 and the poisons of typhoid fever, dysentery, and cholera. 

 Irritant poisons have the same effect. Certain intestinal irri- 

 tants are generated in the body itself, such as urea, the poison 

 of gout (chiefly uric acid), and the poison of pyaemia. Nervous 

 disturbances may produce diarrhoea, for example, anxiety and 

 fear. Disorders of the general and abdominal circulation are 

 frequently attended by a watery flow or flux from the bowels, 

 as in diseases of the liver and heart, or as the result of chill. 

 Lastly may be mentioned organic disease of the intestines. 

 The student must carefully note that diarrhoea, although of 

 much importance in itself and as a cause of further disorder, is 

 but a symptom, the anatomical condition on which it depends 

 varying greatly. 



In connection with excessive activity of the intestines must 

 be taken here certain conditions, such as hernia, peritonitis, and 

 perforation of the bowel, in which any peristaltic movement of 

 the intestine, however slight, must be considered excessive 

 because highly dangerous, and in which paralysis of the 

 intestine for the time being is urgently required. 



2. Deficient Intestinal Action. Constipation is even more 

 common than diarrhoea, and is peculiarly apt to appear in a 

 chronic form. Of its causes, we may select as illustrative 

 examples certain kinds of food, already noticed ; chronic gastric 

 and duodenal dyspepsia, especially in connection with biliary 

 disorder; sedentary or careless habits; and certain specific 

 substances, such as lime and lead, admitted in the food or 

 otherwise. Habitual constipation is generally due to loss of 

 irritability and vigour of the nervo-muscular structures from 

 very chronicity of the state and neglect of regular defaecation ; 



