This is the name given to the well-known severe twisting or griping pains in the belly, usually due to excessive flatulence, and resulting from constipation, or some error of diet.
Treatment.—Hot fomentations should be applied to the belly, or better still, the Instra, which is the best means of applying continuous heat to any part of the body. A turpentine enema (a tablespoonful to a pint of warm water) will nearly always cut short the symptoms; in the absence of turpentine, give warm water alone. A full dose of opium (20 minims) should also be given if the pain is severe, preferably in a tablespoonful of castor oil.
Bicarbonate of soda, carbonate of ammonia and ginger should be freely given in full doses, and the bowels should be well opened as soon as the severe pain has passed off.
Concussion of the Brain.
This term is applied to the partial suspension of the functions of the brain, produced by the severe shaking of its substance by a fall or blow.
Symptoms.—At first the patient lies in an unconscious condition, skin cold and clammy, pulse and breathing very feeble, and temperature extremely low; he can be slightly roused by shouting; he cries out if he is moved, or when painful applications are made, but quickly relapses into insensibility. The stage of unconsciousness may pass off almost at once, it may be prolonged for hours or days, or the patient may never recover from it. The second stage—that of reaction—is marked by returning consciousness and frequently by vomiting, the skin becomes warm, and gradually the patient recovers; on the other hand, inflammation of the brain may set in, or he may again become unconscious and die.
Treatment.—Keep the patient perfectly quiet in bed, in a darkened room, give a milk diet, and if he is much excited, apply cold cloths or an ice-bag to the head. If there is much prostration apply a hot-water bottle, and restore the circulation by rubbing the limbs. When reaction sets in, give five grains of calomel.
Stimulants should be avoided in cases of concussion of the brain, unless the collapse is very alarming (when ammonia should be given), as they tend to cause too violent reaction, which might be followed by inflammation of the brain and its coverings.
Constipation.
This condition is very frequent in tropical climates, where it is associated with sluggishness of the liver. One of the best remedies is the two-grain tablet of cascara, of which one may be taken three times a day. Rhubarb is also a very useful drug. In addition to this, an occasional dose of a saline purge should be used, or a large enema of soap and water may be given. Five grains of blue pill or three grains of calomel will be found to act as a very efficient aperient, especially if followed in about six hours by a saline such as fruit salt. Castor oil is a valuable remedy, but it must be remembered that in the tropics its effects are sometimes rather severely felt, and hence it is well to give it in somewhat smaller doses than those usually employed in temperate climates. Three-quarters of an ounce may be given where an ounce would otherwise be employed.