Diagnosis

Pain more or less severe; griping, tearing, cutting, grumbling or rumbling in different parts of the abdomen, but particularly about the navel; the pain generally comes on in paroxysms. The abdomen is sometimes drawn in, at others distended and tense; the pain is generally relieved by pressure, the bowels seldom being painful to the touch, unless the disease is gradually assuming the character of inflammation of the bowels. These symptoms are frequently attended by vomiting, more or less violent; the bowels, as a general thing, in simple colic, are constipated.

1. Inflammation of the stomach, and Hernia may be mistaken for simple colic, and yet, with a little care, they may very readily be distinguished. The absence of fever, except in exceedingly violent paroxysms, the pain being relieved by pressure, the aspect of the countenance, and the quiet, soft pulse, will distinguish it from inflammation of the bowels. It may very readily be distinguished from hernia by the absence of the small hernial tumor, which is present in the latter affection.

Causes

Among the prominent causes we may enumerate, errors in diet, dissipation, mental trouble, constipation, flatulent food, cold, and all those causes which have a tendency to produce inaction of the bowels and derangement of the digestive organs.

It may arise also from uInters useeption" in which a small portion of the intestine passes within itself, forming a stricture, which presents an impassible barrier to the passage of food, when, unless relief is speedily obtained, inflammation may set in, ending in mortification and death. In this, there is at first no fever, but an obstinate, unyielding constipation; vomiting, gradually becoming worse, and pain, which at first is circumscribed to a small space. This form of the disease is by no means of frequent occurrence.

2. Flatulent Colic. - This is very frequent in children, improperly fed, and in dyspeptic persons, particularly those who are poorly nourished, or are addicted to the use of spirits. There is seldom but little sickness, not often constipation, but a painful retention of flatus, an occasional rumbling sensation in the bowels, with emissions of flatulence.

3. Bilious Colic. - In this form of colic, prior to the appearance of the characteristic symptoms, the patient usually suffers under symptoms of disordered stomach and intestines, such as, bitter taste, yellow fur on the tongue, nausea and vomiting. There is thirst, anxiety, restlessness, severe cutting and screwing pain. Bilious vomiting supervenes, and the bowels are freely moved, the evacuations being mixed with bile. The symptoms gradually abate, only the severer forms being attended with much fever, and in those it sometimes terminates in inflammation of the bowels, and death.

4. Painters Colic. - This variety is known by a variety of names, viz. Colica Pictonum, Devonshire Colic, etc.

It is occasioned by being exposed to the action of lead, and is very common among painters, who use the white lead in their paint, as well as among plumbers, and those engaged in smelting ores, or in lead manufactories. At first, there is a loss of appetite, restless nights, and disturbance of the nervous system. This is followed by vomiting, pain in the abdomen, at first in paroxysms, but gradually increasing until it becomes almost constant. There is little or no fever, but headache, pain in the limbs, obstinate constipation, and, after the severe symptoms have passed away, frequently paralysis of the extremities. An almost invariable symptom of Lead Colic is a bluish line, extending along the edge of the gums. Sometimes this bluish-grey tinge extends over the mouth.

Treatment

A warm hath will often produce speedy relief. If convenient, the patient may he seated in the hath, the water coming up to the stomach, the upper part of the body being covered so as to confine the steam, and permitted to remain in this situation ten or twelve minutes. He can then be taken out and covered warm in the bed, bottles of hot water being placed to the feet. When this form of bath is not convenient, warm cloths can be placed over the abdomen.

The prominent remedies are: Belladonna, Colocynth, Nux, Pulsatilla.

For Flatulent Colic: Nux, Bell., Carb.-v., Calc, Cham., Chin., Puls., Sulph., Cocc. may be consulted.

For Bilious Colic: Nux, Coloc, Bry., Merc, Puls., Cham.

For Painter's Colic: Opium, Bell., Alumina, Platina.

With constipation: Op., Nux, Bryonia.

From Indigestion: Cham., Coloc, Sulphur.

From cold damp weather: Pulsatilla.

From Bathing: Nux.

From a strain or a blow: Arnica, Bryonia, Rhus.

See also Symptomatic Index.

The particular indications are:

Nux-Vomica

Obstinate constipation; pressure in the abdomen as from a stone with flatulence; pinching, contractive, or compressive pains; pressure, fullness and tension in the stomach and abdomen; coldness of the extremities, or numbness during the pain; griping and flatulence; pressure on the bladder and rectum; pain in the loins or pressive headache. Particularly indicated in persons of plethoric habit and accustomed to rich living.

Dose

One drop, or eight globules, in a tumbler of water, a table-spoonful at a dose; or three globules, or a powder, dry on the tongue. See also administration at the close of the article.

Colocynth

A prominent remedy, expecially where there are violent cutting and griping pains; tenderness and bruised sensation of the abdomen; cramps in the calves of the legs; restlessness and tossing from the pain; constipation or diarrhoea, and bilious vomiting, particularly after eating. Dose. - Same as Nux.

Pulsatilla

Shooting pain; uneasiness, heaviness, fullness, tension, and bruised sensation in the stomach and abdomen, incarcerated flatus, with rumbling, pinching, griping, aggravated by touch; worse in the evening or on lying down; general heat; pain in the loins when rising; nausea; diarrhoea; paleness of the face; pressive headache.

Dose

Two drops, or eight globules, in a tumbler of water, a table-spoonful at a dose; or three globules dry on the tongue.

Belladonna

Pinching and drawing with a pressure downward, increased by motion; swelling between the stomach and navel, relieved by pressing; or pain in the stomach as if the intestines were grasped by finger nails; or spasmodic constriction in the abdomen with burning and pressure in the small of the back; or congestion of blood to the head, redness of face, and pain of the most violent character. Mercury or Hyosciamus are often suitable after Belladonna.

Dose

Same as Pulsatilla.

Chamomilla

Particularly in children, or when the attack is brought on by violent anger or chagrin. There are tearing, drawing pains, with restlessness; nausea, bitter vomiting, or bilious diarrhoea; bruised pain through the loins; incarcerated flatus with anguish, tension, and fullness in the stomach; pressing down; cheeks alternately pale and red. Pains worse and night, in the morning, or after a meal. Pulsatilla suits well after Chamomilla.

Dose

Same as Pulsatilla.

Arsenicum

Violent pain with great anguish; griping, spasmodic, corroding pain, with great burning, or sensation of cold in the abdomen; nausea or vomiting; thirst, shivering and debility; worse at night or after eating or drinking.

Dose

A powder, or three globules, dry on the tongue, every two or three hours.

Carb

veg. - Distension of the abdomen with incarcerated flatus, rumbling, belching of wind; pressive pain in the head; general heat, obstinate constipation, hemorrhoids.

Dose

Same as Arsenic.

China

Distension of the abdomen with fullness and pressure; or spasmodic constrictive pains, incarcerated flatulence; especially when the pains appear at night, or in those who have been weakened by debilitating losses, as diarrhoea, loss of blood, etc.

Dose

Same as Pulsatilla. Give morning, noon and night.

Cocculus

Constrictive spasmodic pains, with flatulence, nausea, shortness of breath and distension of the stomach; or sensation of emptiness in the abdomen; tearing and burning in the intestines, with clawing in the stomach; nausea, constipation, anguish, and nervous excitability.

Hyosciamus

Similar to Belladonna. Pain in the head, restlessness, tenderness, hardness and distension of the abdomen, griping or spasmodic pain with vomiting.

Coffea

Violent almost delirious pain; agitation, grinding of the teeth, oppression of the stomach, convulsions, coldness of the limbs and suffocation.

Phosphorus

Flatulent colic, deep in the abdomen.

Ignatia

Nightly colic, shooting in the vicinity of the spleen; incarcerated flatulence with difficult emission.

Mercurius

Tenderness of the abdomen, when touched; pains worse at night, particularly after midnight; hiccough, morbid appetite; nausea, salivation, eructations or slimy diarrhoea; tensive burning or shooting pains, or violent and contractive, with distension and hardness of the abdomen, especially around the navel.

Sulphur

In haemorrhoidal colic, if the desired effect has not been obtained from Carb-v., or Nux-vom.; or in bilious colic, when neither Chamomilla or Colocynth has produced relief; or in flatulent colic after Cham., Coca, Nux or Carb.-v.

Lycopodium

Enormous quantity of flatulence, especially after eating; with pressure, distension, and fullness in stomach and abdomen; constipation.

Calcarea

In flatulent colic, or where it arises from acidity of the stomach.

Bryonia

In bilious rheumatic attacks; after taking cold, with diarrhoea. Alternate with Rhus.

Opium

Especially in Painters' colic, heaviness in the abdomen, which is hard and distended; obstinate constipation, with vomiting or involuntary stools.

Veratrum

Burning in the abdomen, tenderness, and cutting pains; rumbling and flatulence with difficult stools. Alternated with Arsenicum, or Coffea.

Platina, especially in lead colic, or in consequence of fear, or anger; contractive pain in the abdomen and stomach, with sensation of bearing down; sad, melancholy mood. Particularly indicated for females.

Administration

In violent cases of colic, particularly where there is Intersusception, in bilious colic with obstinate constipation, injections may be necessary. If so, a pint of cold, or tepid water, may be thrown into the bowels. If this does not answer, it can be again repeated with the addition of a teaspoonful of salt, the water made sweet with molasses.

In violent cases, the remedies, prepared as directed for Pulsatilla or Arsenic may be given every twenty or thirty minutes, gradually increasing the time, as the symptoms are relieved, to two or four hours. If after four or five doses have been given, no relief is obtained, the medicine should be changed.

Diet And Regimen

Food easy of digestion, carefully avoiding all flatulent diet, and food which the patient has found at times to disagree with him.