170 ENTERITIS. , 
to the feet as may be possible. Being there, the points of the compressed 
fingers are brought to bear upon the center of the anus; gentle and 
equable pressure is maintained until the resistance of the sphincter mus- 
cle is tired out; even then, no haste is warranted. Upon the hand 
penetrating the body, a cavity is eutered; here there is generally some 
dung, the removal of which constitutes what is called “back-raking.” 
In enteritis, the excrement is hard, dry, offensive, in small and dark 
lumps, upon the surface of which lie streaks of white mucus. This being 
done, the arm must be regreased or again moistened with water, and the 
hand gradually advanced to ascertain the temperature of the intestines. 
If the health be undisturbed, the operator will be conscious only of a 
genial glow; should inflammation exist, the augmentation of the natural 
heat will be most decided. 
All is then certainty; no further doubt is justifiable, and no additional 
symptom need be looked for. The nature of the case is determined, 
and should it be enteritis, every moment is indeed precious. Firstly, 
neither bleed nor purge. A particular kind of venesection, however, 
is allowed. Extract one quart of blood, and inject into the vein one 
pint of blood-warm water; a profuse purgation and perspiraticu almost 
immediately follows the disappearance of the fluid. Munch uncertainty 
is thus spared; and two conditions, both favorable to recovery, are 
induced. 
For this operation a quart syringe should be employed; a fine curved 
nozzle should be affixed to it for the convenience of inser- 
tion down the vein; the tube connected with the handle 
should be marked to show when a pint has been forced out 
of the instrument. 
The reason for using a larger and a less handy machine 
than seems absolutely necessary to perform a delicate opera- 
tion is, because nearly all syringes suck up a portion of 
air, which, when the instrument is almost empty, comes 
forth. Now breath or atmosphere, or gas of any kind in- 
jected into a living vessel, speedily destroys life. To pre- 
vent so fearful an accident the enlarged capacity of the 
syringe is recommended. 
ee The water being injected, should the pulse regain its 
iseot_1N70 inflammatory character, mingle half a drachm of aconite 
wax Due Toot; in powder, with every subsequent antispasmodic 
draught. The ethereal drenches must be continued, be- 
cause pain of the intestines is always obstinate, and we cannot be cer- 
tain how far spasm may cause the agony, seeing that a form of colic 
always attends on enteritis. 
