Massage And Gymnastic Exercises

Massage is frequently employed in functional diseases of the intestine. Its field of usefulness lies principally in neurotic and atonic conditions. Massage should be applied by well-trained and experienced persons. Abdominal massage requires great care, as too rough manipulation is liable to do great harm. Gymnastic exercises and sports are well adapted to stimulate and strengthen the muscles of the abdomen as well as those of the intestine. Ewald particularly recommends rowing in boats with sliding seats as an exercise which gives definite results in chronic intestinal torpidity. Golf, billiards, horseback riding, bicycle riding, walking may also be included among the exercises contributing to a toning up of the system.

Hydrotherapy

Moist applications in the form of either Priessnitz's compresses or poultices are often of benefit. Priessnitz's compresses are stimulating, while the warm fomentations serve as a sedative. The latter are applied to allay pain, the heat producing a temporary paralysis of the superficial sensory nerves. Instead of either cold or warm compresses a rubber bag filled with either cold or hot water may be applied. When warm applications are required they can also be used in the form of the Japanese box. Sitz baths of various temperatures may be employed. A shower bath, especially over the abdomen, of cold or warm water or of alternating cold and warm water, is also of benefit. Many of these procedures may be combined with massage, and in this way the curative action is enhanced.

Electricity

The fara-dic, galvanic, or frank-iinic currents are employed. All these three can be used percuta-neously; the first two also intrarectally. The faradic current is mostly applied in atonic conditions of the bowel with the object of stimulating the motor function of the intestines. The galvanic current is principally employed in painful intestinal affections of neurotic character. The franklinic or static current may be advantageously used in both conditions. For the intrarectal application of the current I use an electrode which in principle is very similar to that of Boudet 1 and consists of a perforated hard-rubber end piece in which is lodged a metallic button connected by means of a wire with the battery. To the upper end of the hard-rubber piece is attached a soft-rubber tube leading to an irrigator and provided with a stopcock (see Fig. 27). Proceed as follows: The irrigator is filled with water at blood temperature. The hard-rubber piece, or the rectal electrode, is smeared with vaseline and introduced into the rectum. Another plate electrode is moistened and placed over the abdomen, the stopcock partly opened, and the current applied. The water running from the end piece of the electrode into the bowel carries the electricity along with it.

The electrical application should last from five to ten minutes, the amount of water used varies from ten to fifteen ounces. The outflow of the water can be regulated by the stopcock arrangement. I have applied both the faradic and galvanic currents with this apparatus and found it very convenient. The faradic current may be applied as strong as the patient can bear, while the galvanic current should be used with the negative pole in the rectum, the intensity of current ranging from eight to fifteen milliamperes.

Rectal Electrode

Fig. 27. - Rectal Electrode.

1'Boudet: Cited after A. Mathieu: "Treatment of Diseases of the Stomach and Intestines, " New York, 1894, p. 171. 6