This section is from the book "Smith's Family Physician", by William Henry Smith. See also: Natural Physician's Healing Therapies: Proven Remedies that Medical Doctors Don't Know.
It is of great consequence to distinguish between the symptoms of Inflammation of the bowels and Colic, as the remedies that would be proper and beneficial in Colic would be highly injurious in Inflammation of the bowels.
The pain of Inflammation of the bowels is increased by pressure. The pain of Colic is not only not made worse, but is actually mitigated often, by pressure; and it usually intermits entirely. When there is simply flatulent distension of the intestines, pressure does sometimes increase the patient's uneasiness; but the uneasy sensation is very different from that acute suffering which shrinks from the touch, in inflammation of the bowels. In the latter complaint too, there are paroxysms of severe pain, caused probably by the natural movements of the bowels, or by the temporary distention of the inflamed parts of the bowel; and the pain has frequently a twisting character: but there is not any thorough intermission. There is a duller abiding pain between the sharper fits. It is to be observed too, that the patient lies on his back, with his knees drawn up, as in inflammation of the peritoneum, and is fixed in that position, and for the very same reasons. If, in his agony, he tosses about his arms, the body is kept motionless, and he breathes entirely with his chest; whereas, in mere Colic, the mode of breathing is not altered, and the patient is apt to be turning and writhing in all postures, and out of one posture into another.
The nausea and vomiting are often most distressing. The patient not only rejects immediately whatever food, drink, or medicine he swallows, but he has fits of retching when the stomach is empty. In some instances, matters are cast up having the appearance of liquid faeces; and it is said that injections, introduced into the bowel below, have been voided by the mouth.
Although the fever at the outset may be high, and the pulse sharp and hard, it soon becomes small and wiry; or weak, and like a thread. In bad cases, as the disease proceeds, the abdomen begins to swell, becomes tympanitic; hiccup sometimes comes on; the pulse intermits, or beats irregularly; the extremities grow cold; the features are sharpened or ghastly; cold sweats break out; the pain ceases perhaps. The head is generally unaffected. Now and then the delirium occurs late in the disease; but much more frequently the intellect remains clear to the very last. Death begins at the heart, and the patient dies of exhaustion.
There are many causes within the body which may give rise to inflammation of the bowels, as strangulated hernia; the passing of one fold of the bowels into another, so as to obstruct the passage; or a tumour pressing upon the intestine from without; or some foreign substance or morbid accumulation, plugs it up.
Inflammation of the bowels may arise from cold or wet applied externally, and especially to the feet and legs. Cold is thought to be particularly injurious in this way when the exposure happens soon after a meal.
The mechanical impediments that accumulate within the bowels are still more various in kind than those which constrict it from without. Hardened fecal matters, intestinal concretions. Persons who are in the habit of taking a good deal of Magnesia or Chalk, to relieve acidity and heartburn, are liable to have these substances accumulate, and become hardened in the bowels. They generally begin to collect around some accidental nucleus: a cherry stone, a fish-bone, or a gall-stone, that has found its way into the bowels. "Even a pill, prescribed to cure, may thus come to kill one's patient." Professor Prout was asked to analyze certain odd-shaped, triangular bodies which had been voided at stool, and were supposed to be gall-stones, but he found that they were specimens of Plummer's pill, which had defied the solvent power of the gastric juice, and had passed into, and had lingered in the bowels. Unbruised mustard seed., and carbonate of iron, are other remedial substances which, administered injudiciously, have collected in hard masses, and caused intestinal disease. It is but seldom that we can discover, during life, what is the exact nature of the mechanical obstacle.
When the symptoms of intestinal obstruction, obstinate costive-ness, pain and sickness, set in suddenly, there is some reason to fear some state analogous to strangulated hernia. In such a case, every part of the body where a hernia would be likely to show itself, must be carefully examined.
Inflammation of the bowels requires much the same treatment as inflammation of the peritoneum. The patient must abstain from every sort of stimulant, and confine himself as strictly as possible to the horizontal position. The belly must as soon as possible be covered with leeches, (for a grown person twenty or thirty may be applied,) and afterwards with poultices or fomentations. The leeches may be repeated next day, if necessary. Should one spot or particular portion of the belly be more painful and tender than another, there the leeches should be placed. Purgatives should not be given, but injections of warm water, Castor Oil in thin gruel, or warm Linseed Oil may be given. The bowels will generally act of their own accord, when the inflammation is subdued.
Of internal medicines, Opium is the most useful. It allays pain, it moderates or prevents dangerous peristaltic movements of the inflamed bowel, it often settles the irritable stomach, favours a determination to the skin, and improves the pulse. It is best given in the form of a pill, as in that it is most likely to remain on the stomach. It may be given in pills of one grain each: but must not be given too often, or the remedy may be as bad as the disease. One pill in twelve hours, will generally be sufficient, unless one should be rejected by vomiting, within a short time after it is taken, when another may be administered. The Bromide of Potash and Hydrate of Chloral, in ten or fifteen grain doses, would probably be useful for the purpose of allaying pain, and composing the patient.
In the advanced stage of the disease, symptoms of sinking often come on: a total cessation of pain, failure of the vital powers, and coldness of the body. These symptoms, this collapse and approach to fainting, are generally considered to denote gangrene, and therefore a hopeless state of disease. Yet, in many cases which have proved fatal after similar symptoms, not a trace of gangrene has been discoverable. So that this unpromising change in the symptoms does not always indicate a morbid condition which is necessarily fatal. And if the patients are to be saved at all, they are to be saved by wine and nourishment; otherwise they will die of exhaustion.
Dr. Abercrombie relates the following case: "A man, aged forty, was affected with inflammation of the bowels in the usual form, for which he was treated in the most judicious manner, by a respectable practitioner. On the fifth day the pain ceased; the pulse was 140, and extremely feeble and irregular: his face was pale, the features were collapsed, and his whole body was covered with cold perspiration; his bowels had been moved. In this condition 1 saw him for the first time. Wine was then given him, at first in large quantities, and upon the whole, to the extent of from two to three bottles, during the next twenty-four hours. On the following day his appearance was improved; his pulse 120, and regular; the wine was continued in diminished quantity. On the third day, his pulse was 112, and of good strength; and in a few days more he was well."
Dr. Abercrombie relates other cases of the same kind. They teach us that we must not abandon our patients in despair, even under the most adverse circumstances. If diarrhoea should come on with this state of collapse, Opiates must be joined with the wine. External warmth is also a powerful auxiliary, and bottles filled with water may be placed at the patient's feet, and also laid by his side in the bed.
Injections of warm Beef Tea and warm Milk may also be given to the patient. They will be soothing to the bowels, and will also impart a certain amount of nourishment; and, if necessary, a few drops of Laudanum may be added to the injection.
Sometimes patients will live for as long as four, five, or six weeks without any evacuation from the bowels; and Dr. Watson mentions attending a lady who lived for forty-six days after the last stool.