The symptoms here are nearly the same as in the foregoing disease; only the pain, if possible, is more acute, and is situated lower. The vomiting is likewise more violent, and sometimes even the excrements, together with the clysters, are discharged by the mouth. The patient is continually belching up wind, and has often an obstruction of his urine.
While the pain shifts, and the vomiting only returns at certain intervals, and while the clysters pass downwards, there is ground for hope; but when the clysters and fæces are vomited, and the patient is exceeding weak, with a low fluttering pulse, a pale countenance, and a disagreeable or stinking breath, there is great reason to fear that the consequences will prove fatal. Clammy sweats, black fœtid stools, with a small intermitting pulse, and a total cessation of pain, are signs of a mortification already begun, and of approaching death.
REGIMEN.——The regimen in this disease is in general the same as in an inflammation of the stomach. The patient must be kept quiet, avoiding cold, and all violent passions of the mind. His food ought to be very light, and given in small quantities; his drink weak and diluting; as clear whey, barley-water, and such like.
MEDICINE.——Bleeding in this, as well as in the inflammation of the stomach, is of the greatest importance. It should be performed as soon as the symptoms appear, and must be repeated according to the strength of the patient, and the violence of the disease.
A blistering plaster is here likewise to be applied immediately over the part where the most violent pain is. This not only relieves the pain of the bowels, but even clysters and purgative medicines, which before had no effect, will operate when the blister begins to rise.
Fomentations and laxative clysters are by no means to be omitted. The patient’s feet and legs should frequently be bathed in warm water; and cloths dipped in it applied to his belly. Bladders filled with warm water may likewise be applied to the region of the navel, and warm bricks, or bottles filled with warm water, to the soles of the feet. The clysters may be made of barley-water or thin gruel with salt, and softened with sweet oil or fresh butter. These may be administered every two or three hours, or oftener, if the patient continues costive.
If the disease does not yield to clysters and fomentations, recourse must be had to pretty strong purgatives; but as these, by irritating the bowels, often increase their contraction, and by that means frustrate their own intention, it will be necessary to join them with opiates, which, by allaying the pain, and relaxing the spasmodic contractions of the guts, greatly assist the operation of purgatives in this case.
What answers the purpose of opening the body very well, is a solution of the bitter purging salts. Two ounces of these may be dissolved in an English pint of warm water, or thin gruel, and a tea-cupful of it taken every half hour till it operates. At the same time fifteen, twenty, or twenty-five drops of laudanum may be given in a glass of peppermint or simple cinnamon-water, to appease the irritation, and prevent the vomiting, &c.
Acids have often a very happy effect in staying the vomiting, and appeasing the other violent symptoms of this disease. It will therefore be of use to sharpen the patient’s drink with cream of tartar, juice of lemon; or, when these cannot be obtained, with vinegar.
But it often happens that no liquid whatever will stay on the stomach. In this case the patient must take purging pills. I have generally found the following answer very well: Take jalap in powder, and vitriolated tartar, of each half a drachm, opium one grain, Castile soap as much as will make the mass fit for pills. These must be taken at one dose, and if they do not operate in a few hours, the dose may be repeated.