Diseases of the Bowels. 8 1 



diagnosing correctly between enteritis and colic, and from 

 what I there mentioned, it will be gathered that stimulants 

 and cordials form no part of our treatment in this disease. 



Our first duty is, if possible, to ascertain the cause. Pur- 

 gatives usually, in enteritis, are not advisable. Wheii 

 however, the illness can be traced to local irritation from the 

 impaction of faeces, worms, or foreign matter, a mild dose of 

 castor-oil may be given at the onset with benefit. 



Again, if the liver be associated with it, a small dose of 

 aloes and calomel can also be administered with safety. If, 

 on examination per rectum, impaction of hardened faeces 

 are found, they should be gently broken down with the 

 finger, and a simple warm-water enema thrown up to assist 

 their expulsion. Drastic purgatives at any period of the 

 disease are hurtful, and removal of the obstruction, if pos- 

 sible, by mechanical means is decidedly preferable. Salad 

 oil is a valuable agent for this purpose ; it effects its object 

 by insinuation through the obstruction, supposing it to be 

 the impaction of faecal matter ; it, at the same time, shields 

 the mucous membrane, and if there is intus-susception it 

 facilitates its removal. 



To relieve the pain, from i to 3 grains of opium may be 

 given in a teaspoonful or two of barley-water, and repeated 

 in an hour if necessary. Opiate enemas can also be ad- 

 ministered with the same view. 



Counter-irritation to the abdomen is of great value, mus- 

 tard plasters, hot linseed-meal poultices, bags of hot salt 

 continually renewed, or hot fomentations may be used. 



Bleeding is beneficial in the early stage only, and is best 

 adopted locally, by means of leeches to the abdomen. 



When the acute symptoms have subsided the counter- 

 irritation may be discontinued, but the abdomen must be 

 kept thoroughly warm and the patient quiet. 



With regard to support during the illness, bland mucilagi. 

 nous drinks should form the only diet, and should be con- 

 tinued for some considerable time after recovery takes place^ 



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