178 DISEASES OF THE DIGESTIVE APPARATUS. 



Treatment. We can only treat with any success those contrac- 

 tions of the rectum which are accessible to the hand. We must try 

 to obtain enlargement of the bowel by means of a frequent intro- 

 duction of the arm. The contractions located upon other parts of 

 the digestive canal, especially those of the small intestine, cannot 

 be the subject of any useful intervention. 



7. COLICS DUE TO DILATATION AND PAEESIS OF THE INTESTINE. 



Etiology. Dilatations of the intestine are ordinarily secondary, 

 and produced by pre-existing contractions (neoformations, constric- 

 tions, coprostasis, calculi, invagination, etc.). We find these imme- 

 diately in front of these obstacles. Dilatation is more rarely due 

 to paresis of the intestinal wall, consecutive to its extreme disten- 

 tion, produced by gases or alimentary matters, or indirectly through 

 embolic obstruction of the intestinal arteries. Circumscribed dila- 

 tations of the intestinal canal are generally the consequence of 

 partial ruptures. We do not yet kuow anything definite about the 

 relations which seem to exist between certain dilatations of the 

 gastro intestinal walls and chronic gastro-intestinal catarrh, or the 

 nutritive troubles related thereto. At all exents, the walls of the 

 dilated intestinal portion are much hypertrophied. 



The dilatation of the stomach may be due to pyloric contraction, 

 but also to a contraction located more or less upon the intestine ; it 

 is produced passively through stagnation of the food. 



Symptoms. The intestinal dilations and paresis which are the 

 most important from a practical point of view are those located 

 upon the rectum. They determine chronic, intermittent, and tena- 

 cious colics, which may end in intestinal rupture. 



The rectum is filled with packed fecal matters, the extraction of 

 which puts an end to the colic. There are cases where these mat- 

 ters produce a compression upon the pelvic portion of the urethra, 

 the consequence of which is the retention of urine in the bladder, 

 the dilatation of this organ and hypertrophy of its walls (Fried- 

 berger). 



In considerable dilatation of the stomach the pressure exerted by 

 that organ upon the diaphragm may produce grave dyspnoeic symp- 

 toms during the course of the ailment. Leisering has described a 

 case of dilatation of the stomach in which the great curve between 

 the cardia and the pylorus measured 130 centimetres, and the small 

 one 90 centimetres. 



