Spasmodic Stricture of the lower part of the bowels is known by great difficulty in evacuating the bowels, with spasmodic pain in doing so. It generally depends, says Mr. Mayo, on a vitiated state of the secretions; and is more frequently relieved by a regulated diet and alterative medicines, and the use of injections, than by the employment of the bougie.

Permanent Stricture

In this complaint there is a chronic thicken-, ing and contraction of the lining coat of the bowel, so as to form a ring in it. It is generally situated at from two inches and a half to four inches from the anus. Occasionally it is met with higher up. The symptoms are great pain, straining and difficulty in void-ing the faeces, which are passed in small, narrow, flattened frag-ments; and, on examination the stricture may in ordinary cases be readily felt. Irritation of the bladder and womb, and pains or cramps in the legs, with headache and indigestion, are occasional additional symptoms. If this state is not relieved, it leads to ulceration of the bowel above the stricture, with a consequent aggravation of all the symptoms, and death from irritation. Treatment. - The remedies are aperients (such as Milk of Sulphur and Lenitive Electuary) and injections, so as to produce daily soft, unirritating stools, and the bougie. A soft bougie, capable of being passed with moderate facility through the stricture, should be introduced once in three or four days, and be allowed to remain fifteen or twenty minutes; and its size should be gradually increased when a larger one admits of being passed. Instruments of every sort introduced into the bowel should be handled with the utmost gentleness. Nothing is gained by forcing a large bougie through a stricture. The cure is to be effected by the repeated and gentle stimulus of pressure, so as to excite absorption, not by mere mechanical dilatation. There are numerous and fatal instances on record in which the bowel has been torn by bougies, in the hands of careless or ignorant people.