Intellecute

“ At other times it is attended with strong and full pulse like other inflammations of internal membranes. Can the seat of the disease being higher or lower in the intestinal canal, that is, above or below the valve of the colon, produce this difference of pulse by the greater sympathy of one part of the bowels with the stomach than another? In enteritis with strong pulse the pain is great about the navel, with vomiting, and the greatest difficulty in procuring a stool. In the other, the pain and fever is less, without vomiting, and with diarrhœa. ”

“ The iliac passion, passio iliaca of the old Latin, is usually taken to signify some obstruction of the intestines causing severe pain, vomiting, and eventually fecal vomiting. A good many different forms of severe painful conditions, especially all those complicated by peritonitis, were included under the term, and the modern student of surgery is likely to won [Pg 280] der whether these old observers had not noted that the right iliac region was particularly prone to be the source of fatal conditions. ”

“ When the irritation is further down the intestine, as when an ulcer is situated in the rectum, there is a constant desire to go to stool, but the only results of the expulsive efforts involved in its gratification are exhaustion of the patient and aggravation of the ulcerated condition. ”

“ Infliction, misery, are everywhere. The taint of auto-generated intestinal morbific products, carried and communicated to the remotest parts, manifests itself now here now there as if it were a local trouble, and it is difficult therefore, nay, impossible, to classify scientifically the symptoms of auto-infection. A classification, though necessarily imperfect, will aid in the diagnosis and treatment of the various abnormal conditions of the stomach and intestines, that is, of mal-digestion. ”

“ But it is not correct, and it is on all grounds undesirable, to regard the less powerful man as a sufferer from indigestion, that is, as liable to any complaint to be so termed. True indigestion, as a manifestation of a diseased stomach, is comparatively quite rare, and I have not one word to say of it here, which would not be the fitting place if I had. Not one person in a hundred who complains of indigestion has any morbid affection of the organs engaged in assimilating his food. ”

“ FOREIGN BODIES IN THE INTESTINES OF SOLIPEDS. Sand, pebbles, earth, lime, nails, pins, needles, coins, shot, cloth, leather, rubber, sponge, tooth, bone, wood, twine. Symptoms: as in intestinal indigestion or calculi, or sand or pebbles in fæces; peritonitis, phlegmon. Lesions: congestion, catarrh, ulceration, abscess, needles may travel to other organs. Treatment: laxative, enemata, or as for calculi.
All sorts of foreign bodies are taken in with food and water and find their way to the intestines. ”

“ V. Inverted motions of the intestinal canal with all the lymphatics, which open into it, constitute the ileus, or iliac passion; in which disease it sometimes happens, that clysters are returned by the mouth. ”

“ The intestine is straight from one end to the other but in this straight, and consequently short intestine, is a winding, cork-screw, spiral passage, through which the food, not without several circumvolutions, and, in fact, by a long route, is conducted to its exit. Here the shortness of the gut is compensated by the obliquity of the perforation.” This structure of intestine, which all the true Placoids possess, and at least the Sturiones among existing Ganoids, seems to have been an exceedingly common one during both the Palæozoic and Secondary periods. ”

“ As the disease very often implicates the stomach (gastro-enteritis) , the usual lesions of gastritis will be seen. Most commonly the lesions are best marked in the small intestine, and again in other cases in the colon, but usually there is more or less change in all parts of the intestinal canal. The small intestine is almost devoid of aliments and the mucosa deeply congested in patches or striæ, with at points thickening, softening so that it crushes under the finger, hemorrhagic discoloration, and even ulceration, and necrotic changes. ”

“ An undue retention of the intestinal excretions is another source of disorder and of disease arising out of civilized life. It is produced by affections of the mind, by indigestion, by inattention to the calls of nature, and mechanical obstruction from organic disease, which last is frequently excited by the retained excretions themselves. ”

“ HOW AUTO-INFECTION AFFECTS THE GASTRIC DIGESTION, AND VICE VERSA.
Frederick the Great said that all culture comes through the stomach. This saying emphasizes pithily the dependence of psychology upon physiology. The stomach with the intestines is certainly the source from which every portion of the body receives its nourishment and most of its diseases. The physiological plus and minus processes leave their reflex on the mind. ”

“ The common understanding of the manner in which food passes through the intestinal canal is that the chyme ejected from the stomach is pressed downward by a peristalsis, which passes slowly over a part or all of the small intestine. The peristaltic waves of the colon are supposed to constitute an independent group, similar to those of the small intestine, but weaker and slower. Movements of the food other than the uninterrupted advance have been mentioned by some observers. ”

“ Treatment.—There is no condition in the whole realm of diseases of childhood where the knowledge of the mother may have such important results as this condition. The most effective time to treat these cases of intestinal indigestion is before the physician is called. There are few diseases in which time is so valuable, so far as final results are concerned, as it is here. ”

“ The local inflammation is at first superficial but the increasing toxicity of the fluids that are held on these parts causes the inflammation to take on ulceration.
The inflammation or ulceration may remain superficial, and be located in the lower portion of the small intestine, then the disease is enteritis. ”

“ The small calibre of the bullet is alone responsible for the favourable results observed.
7. The danger or otherwise of an intestinal injury depends mainly on mechanical conditions; for instance, the fixity of the ascending colon, and its comparative freedom from a covering of small intestine capable by movement of diffusing any infective material, account chiefly for such favourable results as are seen when that segment of the bowel is implicated. ”

“ In consequence of debility, over-exertion, anxiety, or chronic inflammation of the stomach, there is not a proper secretion, in quantity or quality, of digestive solvents, and it matters not whether it be a deficiency of the fluids of the stomach, or of the intestines, or of the pancreas and liver, the result is indigestion. The question of what important agent is lacking, naturally presents itself to the physician. ”

“ ENTERITIS. Enteritis consists in inflammation of the intestine, or, more precisely, in inflammation of the intestinal mucous membrane. All the constituent portions of the intestinal tube may be affected (duodenum, jejeunum, ileum, colon, cæcum) ; but clinical distinctions and localisation of inflammation in the various parts are very difficult in the domesticated animals, and at present it is impossible to describe with any accuracy the differences between duodenitis, enteritis of the jejeunum and ileum, colitis or typhlitis. ”

“ But when food contains no irritating substances and is easily assimilated without forming residues, or when the innervation by the vagus is sluggish and the peristaltic movements are slow, the contents of the intestines can remain longer, especially in the haustra of the intestines. It may be that the bowels move every day, but that does not prove that everything in the intestines has been expelled therefrom, for some amount of fæces can yet remain in the haustra of the intestine even for many days ”

“ The intestine is always filled with brown faeces which are normally expelled in small quantities, only at considerable intervals. Slight peristaltic waves are commonly seen in the lower part of the intestine.
These animals were placed in various solutions, and it was found [97] that pilocarpine hydrochlorate, aloin, cascara, as well as barium chloride, sodium citrate, sulphate, and fluoride, caused an increased peristaltic activity of the intestine, and a rapid expulsion of faeces, so that in a very short time the entire intestine was empty. ”

“ All kinds of foodstuffs, at all hours, with seeds, stones, etc., are poked into its stomach, followed by constipating remedies to quiet inevitable troubles, or brisk purgatives given with the hope of expelling the arrested contents of the bowels. Is it any wonder that ninety-eight persons of adult age out of every hundred suffer more or less from chronic inflammation and ulceration of anus, rectum, sigmoid flexure, colon, or appendix? ”

“ When you tell such patients that their trouble is indigestion, they are often mildly indignant, and loudly protest that they can eat anything with impunity; that they never have heart-burn, feelings of heaviness after eating, pains in the abdomen, or other symptoms referable to the stomach and intestines. We are rather disposed to be proud of our digestive powers, just as we are of our bodily strength, and nothing is more common than for chronic dyspeptics to maintain that they have never had indigestion in their lives, [Pg 146] and to resent any insinuation to the contrary. ”

“ The patient must have suitable nourishment and stimulation, and requires to have the greatest care, whatever special form of treatment is being carried out, while constant watch must be kept for the appearance of any complication. Great differences in the treatment are observed in different countries and by different schools of medicine.
Enteri ́tis (Gr. enteron, intestine) is inflammation of the intestines. It varies from a mild intestinal catarrh, causing slight symptoms, and yielding to treatment in a few days, to cases of severe vomiting and diarrhœa with extreme prostration. ”

“ The hind-intestine.—In many insects this is divided into the ileum, or short intestine, and the long intestine. The limit between the intestine and stomach is externally determined by the origin of the urinary tubes, which are outgrowths of the anterior end of the proctodæum. Like the fore-intestine the hind-intestine is lined with a thick muscular layer, and, as Gehuchten states, the passage from the epithelial lining of the stomach (mid-intestine) to the muscular lining of the intestine is abrupt. ”

“ After the small intestine is opened the enterotome is introduced through the ileocæcal opening and the large intestine cut in the anterior tænia as far as the rectum. The opening of the intestine within the body should be left until all the other abdominal organs have been examined, because of the disagreeable mess made by the escape of the intestinal contents into the cavity. ”

“ In such a complicated organ as the intestine there are many sources of error, and differences of opinion may readily arise if an attempt is made to analyze too closely the functions of the various tissues making up the intestine, to decide for example whether the movements are of nervous origin or muscular, or whether the secretion is dependent primarily on the blood supply or on the nervous system. ”

“ Pustules of the small Intestines.—From δοθη, a pustule, and εντερον, an intestine. This name is given to a disease which has been described by M. Bretonneau, of Tours, and, after him, by Serres, Broussais, Andral, and several others, and consists in pustules, generally situated at the lower end of the ileum.
We are constantly lamenting to ourselves the contracted bounds allotted to our Quarterly Summary. ”

“ Lesions of any sort seated in the intestinal wall, as ulcers and neoplasms, induce paroxysmal pains.
SYMPTOMS.—The pain of enteralgia occurs in attacks which come on slowly and continue for a variable time—some hours or days. The pain is situated about the umbilicus, and is relieved by deep pressure, although at the same time there may be hyperæsthesia of the skin. The intensity of suffering ranges from a dull heavy pain to one which is acute and lancinating. Retraction of the abdomen is common, but there may be tympanites. ”

“ In the present state of our knowledge dysentery would be known by marked tenesmus, by the grave general symptoms, the reddish fluid stools with flocculi, and by its occurrence in epidemic form.
Enteralgia presents the following features which distinguish it from intestinal catarrh: The tongue in enteralgia is clean or coated white, but with no red tip and edges; the appetite is capricious, but not lost; the bowels are constipated; the pain bears no relation to the ingestion of food or drink, as in enteritis. Fever is accidental, and there are other nervous phenomena. ”

“ That intestinal obstruction is not always complete in intussusception is shown by the fact that fecal matter, often in considerable quantity, is passed through the bent and narrowed tube, the intestine retaining, at least for a time, its contractile power. The changes produced by inflammation are chiefly seen in the inner and middle layers of intestine, the receiving or outer layer of the invagination often escaping any serious damage. These changes vary with the character and duration of the inflammation. ”