III. Of the Modification of the Treatment in Abdominal Affection.
No remedy at all comparable in efficacy to the preceding has yet been discovered for the inflammation of the mucous membrane of the intestines, which forms so constant and formidable a part of the organic affection of fever. General bleeding has but little influence over the disease. If employed early and with due activity, it will prevent the affection from occurring, but, when once it has supervened, large bleedings are out of the question, and even small and repeated bleedings are not as effectual as leeches. In severe cases, the abdomen should be covered with leeches, and they should be re-applied daily, until the pain and tenderness are gone, or, at least, have become slight, for it is often impossible entirely to remove the tenderness. The abdomen should be covered with a poultice as soon as the leeches fall off. Afterwards, the application of a linen rag, moistened constantly with the oleum terebinthinæ, keeps up the effect produced by the leeches, and, when the affection is slight, may supersede their use altogether.
When the purging is considerable, five grains of the hydrargyrum cum cretâ, with five of the pulvis ipecacuanhæ compositus, given every night or every night and morning, often checks it; if this remedy fail, a stronger opiate may be exhibited, and sometimes an anodyne enema may be administered with great advantage. If there be constipation, one or two drachms of castor oil is the proper laxative. Active or irritating purgatives are highly injurious.
When blood is mixed with the stools or there is considerable hæmorrhage from the intestines, every thing that can irritate the mucous membrane must be carefully avoided. The mineral acids sometimes appear to check the discharge. The infusion of roses rendered stronger by the addition of a few drops of the sulphuric acid, is a convenient mode of administering such medicines, and the efficacy of the draught is sometimes improved by the addition of a drachm of the tincture of hyosciamus. It is not uncommon for copious discharges of blood to alternate with constipation. In this case the mildest laxative must be administered with caution. The powers of life are sometimes so prostrate, that three or four stools, excited by purgative medicines, are sufficient to exhaust them. A tea-spoonful of castor oil, repeated at intervals of six hours, is all that should be attempted. Now and then a stimulant has a greater effect in checking the hæmorrhage than an astringent, and then the oleum terebinthinæ is the best remedy.