[6]. Ileus. Consists in the inverted motions of the whole intestinal canal, from the mouth to the anus; and of the lacteals and absorbents which arise from it. In this pitiable disease, through the valve of the colon, through the pylorus, the cardia, and the pharinx, are ejected, first, the contents of the stomach and intestines, with the excrement and even clysters themselves; then the fluid from the lacteals, which is now poured into the intestines by their retrograde motions, is thrown up by the mouth; and, lastly, every fluid, which is absorbed by the other lymphatic branches, from the cellular membrane, the skin, the bladder, and all other cavities of the body; and which is then poured into the stomach or intestines by the retrograde motions of the lacteals; all which supply that amazing quantity of fluid, which is in this disease continually ejected by vomiting. See Sect. XXV. 15. for a further explanation of this disease.
M. M. Copious venesection. Twenty grains of calomel in small pills, or one grain of aloe every hour till stools are procured. Blisters. Warm bath. Crude mercury. Clyster of ice-water. Smear the skin all over with grease, as mentioned in Sect. XXV. 15.
As this malady is occasioned sometimes by an introsusception of a part of the intestine into another part of it, especially in children, could holding them up by their heels for a second or two of time be of service after venesection? Or the exhibition of crude quicksilver two ounces every half hour, till a pound is taken, be particularly serviceable in this circumstance? Or could half a pound, or a pound, of crude mercury be injected as a clyster, the patient being elevated by the knees and thighs so as to have his head and shoulders much lower than his bottom, or even for a short time held up by the heels? Could this also be of advantage in strangulated hernia?
Where the disease is owing to strangulated hernia, the part should be sprinkled with cold water, or iced water, or salt and water recently mixed, or moistened with ether. In cases of strangulated hernia, could acupuncture, or puncture with a capillary trocar, be used with safety and advantage to give exit to air contained in the strangulated bowel? Or to stimulate it into action? It is not uncommon for bashful men to conceal their being afflicted with a small hernia, which is the cause of their death; this circumstance should therefore always be enquired into. Is the seat or cause of the ileus always below the valve of the colon, and that of the cholera above it? See Class [II. 1. 2. 11].
[7]. Globus hystericus. Hysteric suffocation is the perception of a globe rolling round in the abdomen, and ascending to the stomach and throat, and there inducing strangulation. It consists of an ineffectual inversion of the motions of the œsophagus, and other parts of the alimentary canal; nothing being rejected from the stomach.
M. M. Tincture of castor. Tinct. of opium of each 15 drops. See Hysteria, Class [I. 3. 1. 10].
[8]. Vomendi conamen inane. An ineffectual effort to vomit. It frequently occurs, when the stomach is empty, and in some cases continues many hours; but as the lymphatics of the stomach are not inverted at the same time, there is no supply of materials to be ejected; it is sometimes a symptom of hysteria, but more frequently attends irregular epilepsies or reveries; which however may be distinguished by their violence of exertion, for the exertions of hysteric motions are feeble, as they are caused by debility; but those of epilepsies, as they are used to relieve pain, are of the most violent kind; insomuch that those who have once seen these ineffectual efforts to vomit in some epilepsies, can never again mistake them for symptoms of hysteria. See a case in Sect. XIX. 2.
M. M. Blister. Opium. Crude mercury.
[9]. Borborigmus. A gurgling of the bowels proceeds from a partial invertion of the peristaltic motions of them, by which the gas is brought into a superior part of the bowel, and bubbles through the descending fluid, like air rushing into a bottle as the water is poured out of it. This is sometimes a distressing symptom of the debility of the bowels joined with a partial inversion of their motions. I attended a young lady about sixteen, who was in other respects feeble, whose bowels almost incessantly made a gurgling noise so loud as to be heard at a considerable distance, and to attract the notice of all who were near her. As this noise never ceased a minute together for many hours in a day, it could not be produced by the uniform descent of water, and ascent of air through it, but there must have been alternately a retrograde movement of a part of the bowel, which must again have pushed up the water above the air; or which might raise a part of the bowel, in which the fluid was lodged, alternately above and below another portion of it; which might readily happen in some of the curvatures of the smaller intestines, the air in which might be moved backward and forward like the air-bubble in a glass-level.
M. M. Essential oil. Ten corns of black pepper swallowed whole after dinner, that its effect might be slower and more permanent; a small pipe occasionally introduced into the rectum to facilitate the escape of the air. Crude mercury. See Class [I. 2. 4. 9].