The Symptoms of Intestinal Obstructions

Persistent vomiting; vomiting of fecal matter; extreme pain; distension of the bowels with gas; hiccough; constipation of the bowels; mental depression; great prostration; tumor, which can be felt through the abdominal walls.

The causes of intestinal obstruction may be divided into six classes, as follows:

Compression. - This cause of mechanical obstruction of the intestines may result from morbid growths of any sort, as various forms of tumor, including cancer, or from a displaced uterus. We have within a week of the date of this writing met with a remarkable case in which the last mentioned cause occasioned the most obstinate constipation for many years. The lady had received treatment from many physicians for a period of eight years, but without relief. During this time there had rarely been a movement of the bowels without the employment of laxatives of some kind. She was in the habit of taking senna at night for the purpose of securing an evacuation of the bowels the next morning. Upon making an examination of the womb, it was found to be completely retroverted, or tipped backward, thus pressing upon the rectum in such a way as to form an obstacle to the downward passage of the contents of the bowels.

Contraction. - One of the worst forms of obstruction is due to stricture or contraction of the intestine, caused by chronic catarrh, dysentery, cancer, or chronic ulcer of the intestine. This kind of obstruction occurs most frequently in the rectum or lower part of the bowels. It is indicated by great difficulty in moving the bowels and the small size of the stools, when formed.

Twisting. - In some manner not easily understood, the small intestine sometimes becomes twisted upon itself so as to form an obstruction. So slight a degree of twisting as one-half rotation is said to be sufficient to close the canal.

Internal Strangulation. - This is one of the worst forms of mechanical obstruction, as it consists in the entanglement of an intestine in a fissure between bands of inflammatory tissue, or the formation of a sort of knot in the intestine itself.

Intussusception. - This form of obstruction is produced by the intestine being invaginated, or folded into itself. One cause of this accident is chronic diarrhea. It is most frequent in children, especially in children suffering with hydrocephalus. The occurrence of this accident is usually indicated by severe pain felt over a certain spot in the abdominal cavity. A tumor may also be generally felt at the seat of pain indicating the point of obstruction.

Hardened Feces. - This cause of obstruction is one which should not be overlooked, as it is one which is not infrequent. Cases are often met in which the feces accumulated in the lower part of the bowels are so hard and dry that they cannot be dislodged by the ordinary efforts of nature. Occasionally, also, stony concretions form in the intestines, of sufficient size to obstruct the intestinal canal. These are generally the result of the use of chalk or magnesia in large quantities, or of accumulations the nucleus of which consists of gall stones or foreign bodies which have been swallowed, such as coins, cherry or plum pits, seeds of raisins, etc. Rupture, or Hernia, is another cause of intestinal obstruction, but as this properly comes under the head of surgery it will not be considered here.