Treatment varies with the character of the bodies ingested, sand and gravel may be passed on by a laxative diet and even by the use of mild laxatives. Bernard gave 10 quarts of water and 4 oz. Glauber salts every hour for eight days, and the same amount by enema. For the larger solid bodies which obstruct the intestines the treatment is the same as for calculus. For sharp pointed bodies causing abscess and fistulæ, we must follow the indications, ever aiming at the discovery of the whereabouts of the offending object and its removal.
FOREIGN BODIES IN THE INTESTINES OF RUMINANTS.
Foreign bodies are usually arrested in the rumen of cattle and unless sharp, pointed or rough so as to cause mechanical trouble or caustic so as to act chemically, rarely do much harm. The most extraordinary objects that have found their way into the intestine are snakes. Gherardi claims that he found in the intestines a snake of 25 inches long; Jager found one of 21 inches in length, in an advanced state of decomposition, in the rectum of a calf. It is supposed that both had been taken in with the food. In each case there was obstruction of the intestine with severe colicy symptoms.
FOREIGN BODIES IN THE INTESTINES OF CARNIVORA.
Small bodies, especially playthings, feathers, hair, bristles, bones of prey. Lesions: congestion, inflammation, hemorrhage, ulceration, perforation, invagination. Symptoms: colic, vomiting, tucked up belly, straining, palpitation, rabiform symptoms, cough, convulsions. Course: emaciation, prostration, death in five days or two weeks according to seat of obstruction. Treatment: Oleaginous injections, laparotomy.
Causes. The dog is especially liable to this form of trouble, in consequence of his habit of carrying objects in his mouth and of playing with different objects especially the playthings of children. Marbles, pebbles, spinning-tops, corks, coins, nuts, peach stones, pieces of rubber, cloth or leather, bits of wood, sponge, needles, pins, potato, bone, cord, hair, bristles, feathers, wire, and a number of other objects. Some of them like feathers, hair, and bones are swallowed with food, and when that has been digested, they are either vomited or failing in this, are passed on into the intestine. Lately the author made a post mortem of a house dog with over 24 inches of the jejunum virtually blocked with fragments gnawed from a caouchouc ball and pieces of twine.
Cats also swallow a variety of objects. Benjamin and Megnin record three cases of intestinal obstruction by the crystal drops of shades.
Lesions. When the lumen of the intestine is blocked with a round solid body like a marble or peach stone there occur active congestion, inflammation, blood stasis and hemorrhage, with in many cases necrosis, ulceration and perforation. Similar lesions occur from cord. In a recent case of impaction with gnawed fragments of caouchouc and cord, the 24 inches of the bowel implicated were the seat of extended patches of necrosis and of deep, and even perforating ulcers on the lesser curvature of the intestine, evidently caused by the tension of the stretched cord on the shorter attached border of the gut. Cadeac says the lesions from cord are always at the point of attachment of the mesentery, whereas those coming from round or cubical solid bodies are mainly on the greater curvature. Mathis found at the pylorus a piece of net from which a cord extended through the small intestine and ended in a ravelled mass near the ileo-cæcal valve. The dragging of the cord on the intestine often causes invagination at one or several points.
Symptoms. There may be slight colic, dullness, a disposition to lie curled up in some secluded place, loss or caprice of appetite, vomiting, tucked up abdomen, arching of the back, straining, and unless the bowels are distended with gas, the obstruction can usually be felt by the two hands applied on opposite sides of the abdomen. The matters vomited are at first alimentary, then bilious and in the advanced stages always feculent.
The French veterinarians assure us that rabiform symptoms are very common as the result of obstruction of the intestines with foreign bodies. The indications are signs of fury without the barking which characterizes genuine rabies. The patient becomes wicked, cross and excitable, sometimes dull and morose, and snappish, his eyes glittering and his mouth frothy. He has alternate paroxysms of fury and torpor, at one time flying at and biting any living thing he meets, or tearing some object to pieces, and at another hiding away in secluded and dark corners. Massenat saw two dogs supposed to be affected by rabies, but which recovered promptly after having vomited the foreign bodies which they had swallowed. In a country where rabies is so prevalent as in France, it would be interesting to see the results of inoculation with some of the most pronounced of these rabiform cases.