ISO PATHOLOGY. 
laxatives in the upper part of the canal, the obftruflion is 
mechanically loofened, in the lower part, by the clyller... 
A folution of aflafoetida, alfo, adminiftered in this way, 
tends both to relieve the pain by its antifpafinodic qua¬ 
lities, and alfo to Simulate the lower bowel to evacua¬ 
tion. But, Where there is very obftinate conftipation, a 
clyfter of more efficacy is one made of turpentine, pro¬ 
perly fufpended in water by means of mucilage or the 
yolk of an egg. In cafes where every purgative medi¬ 
cine has failed, and the moll powerful clyfters have 
proved ineffedlual, the aflion of the bowels may be exci¬ 
ted by throwing cold water on the lower extremities. 
When inflammation does not feem likely to occur, and 
powerful cathartics are required, the oil of croton will be 
found a remedy of great avail. 
It is of much importance, however, to diftinguifh 
fpafm from inflammation of the colon, with which it is 
Sometimes connected, and into which it is likely to run. 
In faff, this always happens before a fatal termination 
takes place. :i nut 
The former is thus diftinguilhed from the latter 
pffeffion. The fymptoms, which imply the fpafmodic 
Hate, are a foft pulfe of natural or of little-increafed fre¬ 
quency; the pain intermitting occafionally, or moving 
from pne part to another, and being, relieved, or at leaft 
not increafed, by external prefl’ure, and the occurrence 
of feculent evacuations, though the lattercircumftance is 
ieldom to be relied cn. The fymptoms, on the contrary, 
which lead to a fufpicionof inflammation, are, unremit¬ 
ting feverily of pain, obflinate conftipation, tenfion of 
the abdomen, and an aggravation of the pain by preflure; 
a very-frequent fmall and bard pulfe; the Ikin being hot 
and dry, or partially moift with clammy fweats ; frequent 
retching, with a dry brown tongue, hiccup; and, above 
all, pain in the head, or difturbance of the cerebral func¬ 
tions. 
Where inflammation is threatened, recourfe fhould be 
immediately had to the lancet, and a free bleeding from 
the arm, from a large orifice, fliould be effedled. In ple¬ 
thoric habits, this operation may require to be repeated, 
if the pain fliould not remit,' and the pulfe fliould remain 
hard and frequent, and if the blood drawn fliould exhibit 
the huffy coat or contraftion of the coagulum. Where 
the fymptoms of inflammation are lefs violent, leeches 
to the abdomen, the warm bath, fomentations, or a blifter, 
may be applied. In ftrong habits, indeed, if the pain 
lias been of confiderable duration, inflammation isalways 
much to be apprehended ; and a moderate venefeftion 
may be beneficially employed in anticipating its aftual 
attack. The tobacco-clyfter is likewife ufeful in violent 
cafes ; but the dreadful effefts this agent is capable of 
producing fliould render us very cautious in the ufe of it. 
Of courfe, opium, an excellent remedy in the fpafmodic 
colic, fliould be entirely profcribed in this. 
In the aggravated form of this attack, afymptom arifes 
which gives name to the difeafe; namely, the ftercora- 
ceous vomiting, or iliac pajfim. In it the periftaltic mo¬ 
tions of the inteftines are totally inverted, and all their 
contents, even clyfters, will be vomited; a circumftance 
always to be accounted highly dangerous; but, if the 
paflage through the inteftines be free, even though their 
periftaltic motion fliould be inverted, there is much more 
hope of a cure than when the belly isobftinately coftive, 
and there is fome fixed obftruftion which feems to bid 
defiance to cathartic remedies. 
Introfufception, ulceration, mortification, See. are the 
ultimate confequences of the inflammatory procefs ; oc¬ 
currences for the moll part fatal, or at leaft only deriving 
alfiftance from furgical operations. 
A very feverc kind of colic is produced by the poifon 
of-lead. It is our next fpecies ; viz. 
2. Colica racbialgia, (C. Piftonum, Cull.) The colic of 
Poitou; otherwife called the painter’s or Devonlhire colic. 
In this difeafe the pain is at firft dull and remitting; but 
' progreflively growing more violent and continued ; ex¬ 
tending to the back and arms, and at laft producing pa- 
ralyfis. We copy the following more detailed account 
of its fymptoms from the Encyclopaedia Britannica. 
“ The patient is generally firft feized with an acute pain 
at the pit of the ftomach, which extends itfelf down with 
griping pains to the bowels. Soon after there is a dif- 
tenfion, as with wind ; and frequent retchings to vomit, 
without bringing up any thing but fmall quantities of 
bile and phlegm. . An obftinate coftivenefs follows, yet 
fometimes attended with a tenefmus, and the bowels 
feem to the patient as if they were drawn up towards the 
back ; at other times they are drawn into hard lumps, 
or hard rolls, which are plainly perceptible to the hand 
on the belly. Sometimes the coats of the inteftines feem 
to be drawn up from the anus, and down from the py¬ 
lorus, towards the navel. When a ftool is procured by 
artificial means, ds clyfters, &c. the feces appear in little 
hard knots like ftieep’s dung, called Jcybala, and are in 
•fmall quantity. There is, however, ufually an obftinate 
coftivenefs ; the urine is difeharged in fmall quantity, 
frequently with pain and much difficulty. The pulfe is 
generally low, though fometimes a little quickened by 
the violence of the pain ; but inflammatory fymptoms 
very feldom occur. . The extremities are often cold; and 
fometimes the violence of the pain caufes cold clammy 
fweats and fainting.. The mind is generally much af- 
fedfed, and the fpirits are funk. The difeafe is often te¬ 
dious, efpecially if improperly treated, infomuch that the 
patient will continue in this miferable ftate for twenty or 
thirty days fucceffively ; nay, inftances have been known 
of its continuing for fix months. In this cafe the pains 
at laft become almoft intolerable : the patient’s breath 
acquires a ftrong fetid fmell like excrement, from a re- 
. tention of the feces, and an abforption of the putrid ef¬ 
fluvia from them by the lafteals. At laft, when the pain 
in the bowels begins to abate, a pain comes on in the 
fhoulder-joints and adjoining mufcles, with an unufual 
fenfation and tingling along the fpinal marrow. This 
foon extends itfelf from thence to the nerves of the arms 
and legs, which become weak ; and that weaknefs in- 
creafes till the extreme parts become paralytic, with a 
total lofs of motion, though a benumbed fenfation often 
remains. Sometimes, by a fudden metaftafis, the brain, 
becomes affedled, a ftupor and delirium come on, and the 
nervous fyftem is irritated to fuch a degree as to pro¬ 
duce general convulfions, which are frequently followed 
by death. At other times,, the periftaltic motion of the 
inteftines is inverted, and a true iliac paffion is produced, 
which alfo proves fatal in a fliort time; Sometimes the 
paralytic affedlion of the extremities goes off, and the 
pain of the bowels returns with its former violence ; and, 
on the ceflation of the pain in the inteftines, the extre¬ 
mities again become paralytic ; and thus the pain and 
palfy will alternate for a very long time.” 
The cure of this dreadful diforder is to be effedfed by 
removing the fpafmodic conftridfion ofthe inteftinal canal. 
In this form of colic there appears to be little difpofition 
to inflammatory adtion ; and therefore, wherever colic 
can be decidedly traced to the operation of lead, we 
fliould adminifter a large dofe of opium, and repeat it at 
fliort intervals, until the pain.(and of courfe the fpafmo¬ 
dic ftridture) is relieved. When thiseffedl has been pro¬ 
duced, we may proceed to excite the adlion of the bowels, 
and procure proper evacuations of feces ; after which, 
the cure is foon completed by tonics and cordials. This 
rndlice of firft: relieving the pain and conftridlion by 
piates,, before the bowels are attempted to be forced by 
purgative medicines, was llrongly recommended by Dr. 
Warren, (Med. Tranfadl. vol. ii.) and was alfo employed 
by Dr. Darwin, (Zoonotnia, vol. ii.) As affifting the 
antifpafmodic operation of opiates, the warm-bath, fo¬ 
mentations, &c. Ihould likewife be reforted to. 
Of the palfy which fucceeds to Colica pibfonum there 
feems to be a tendency in the conftitution, efpecially in 
recent cafes, to recover itfelf, if the exciting caufe is 
i avoided 5 
