8. Mustard plaster over the stomach is good in all cases.
9. One-tenth of a drop of ipecac is good for nausea and vomiting.
10. One-half of a drop of Fowler's solution every two hours is useful in nausea following a spree. So also one drop dose of nux vomica every half hour.
APPENDICITIS.—Inflammation of the vermiform appendix is the most important of acute bowel troubles. Sometimes the appendix may contain a mould of feces, which can be squeezed out readily. Sometimes foreign bodies like pins are found there; in about seven per cent of cases foreign bodies are found.
It is a disease of young persons. Fifty per cent occur before the twentieth year. It is most common in males. Persons who do heavy lifting are quite subject to the disease. Some cases follow falls or blows. Indiscretions of diet are very apt to bring on an attack, particularly in those who have had it before. Pain in the appendix in such persons, frequently follows the eating of food hard to digest. Gorging with peanuts is also a cause.
Symptoms.—In a large proportion of cases the following symptoms are present:—Sudden pain in the abdomen, usually referred to the right groin region. Fever often of moderate form or grade. Disturbances of the stomach and bowels, such as nausea, vomiting and frequently constipation. Tenderness or pain in the appendix region. The pain in fully one-half of the cases is localized in right lower part of the abdomen, but it may be in the central portion, scattered, or in any part of the abdomen. Even when the pain is not in the region of the appendix at first, it is usually felt there within thirty-six or forty-eight hours. It is sometimes very sharp and colic-like; sometimes it is dull. The fever follows rapidly upon the pain. It may range from 100 to 102 and higher. The tongue is coated and moist usually,—seldom dry. Nausea and vomiting are commonly present. It rarely persists longer than the second day in favorable cases. Constipation is the rule, but the attack may start with diarrhea.
Local Signs.—Tenderness of the rectus muscle (to the right of the centre of the abdomen) and tenderness or pain on deep pressure. The muscle may be so rigid that a satisfactory examination cannot be made. Sometimes there is a hardness or swelling in the appendix region. Tenderness, rigidity and actual pain on deep pressure; with the majority of cases, a lump or swelling in the region of the appendix.
[Illustration: Vermiform Appendix.
When Affected by Inflamation and Gangrene
Necessitating an Operation.]
[Illustration: Vermiform Appendix.
Showing Different Types.]