Special Gymnastics

The abdominal muscles may be strengthened by calling them into frequent and strong activity. For this purpose rotation of the trunk toward both sides while standing still, as well as raising the upper part of the body while lying, and similar exercises may be of benefit. These may be continued for about three to six minutes.

Position Of Patient

A suitable position of the patient has been frequently utilized successfully in treating enteroptosis. Lying in bed is of value in preventing the ptosis of the abdominal organs. It would be still better to elevate the buttocks, throwing the abdominal organs from the lower part of the abdomen to the upper regions and keeping them there. Constant rest in bed may be enjoined in grave cases for two to three weeks and longer, combined with elevation of the buttocks for several hours during the day.

Similar in action to lying on the back, which produces a natural replacement of the descended abdominal organs from below upward, is the use of mechanical means for this purpose.

Fig. 70. - Glenard's Bandage.

Means Serving To Decrease The Abdominal Space And To Crowd The Abdominal Organs Upward

Tim relaxed abdominal walla found in enteroptosis can bo strengthened by means of suitable abdominal bandages. Glenard has strongly emphasized this point and constructed a bandage for this purpose (Fig. 70). There are many other similar bandages in use (Figs. 71, 72, 73). In ordering an abdominal bandage it is of prime importance to fit it well so that it will accomplish the desired purpose, viz., keeping the lower part of the abdomen well supported and lifting it somewhat upward. In patients who do not have a pendulous abdomen nor much fat it is important to have fenestra in the bandage over the iliac crests, so as to avoid pressure on these points, and also to attach straps running between the legs, as otherwise the bandage is liable to be displaced upward (Fig. T4).

Fig. 71. - Hard-Rubber Abdominal Supporter.

Fig. 72.

Fig. 73.

At times in cases of very flat abdomen the bandage may have to be provided in addition with a suitable pad covering the lower abdomen, in order to increase the mechanical pressure.

Fig. 74.- Bandage with Holes over the mac Crests, and Strups. around the Legs as.

In such cases A. Rose's 1 method of covering the abdomen with adhesive plaster strips may be employed. The plaster cannot, however, generally supplant a bandage, as the constant presence of the plaster strips in contact with the skin is a source of some discomfort.

Medicinal Treatment

Of medicaments, iron and arsenic are often indicated in anaamic conditions, while the bromides may be given to allay great nervousness. All the digestive disturbances should be managed according to the general rules. This applies also to the constipation which is so frequently present in enterop-tosis. Laxatives, however, should not be habitually resorted to, nor is there any need of laxative treatment in cases in which the bowels are regular.

After having enumerated the procedures used in the treatment of enteroptosis, I would once more lay stress upon the essential points. These are a suitable, sufficient nutrition, general hygienic mode of life, and the wearing of a well-fitting bandage.

1 A. Rose: "Gastroptosis." The Post-Graduate. March, 1900