Baker, Adair, and most writers on this disease. Dr. Pemberton* combined the Tincture with Castor Oil; and Dr. Copland conjoins the first dose or two with Calomel, if the functions of the bowels be obviously affected, and if the stomach be irritable, as it generally is in the advanced stage of the disease. The dose of Calomel should be full (gr. ij. - v.), and not repeated oftener than once or twice.
1967. In Strangulated Hernia, Opium is one of the most powerful auxiliaries which we possess. Prof. Miller places it on a par with Chloroform; and cases in which it has been successfully employed are recorded by Drs. Lyell,§ Bell,|| Mayo,¶ Butler Lane,** and others. The object is to administer Opium until the patient is fairly narcotised, and a complete relaxation of the tissues is produced; under which circumstances the hernia, with but slight, if any, manipulation, can be reduced. To induce this state, a grain of Opium, or half a grain of Morphia, may be given hourly at the same time that emollient and opiate enemas are employed. Dr. B. Lane regards the benefit of this treatment as twofold: 1, it subdues the local and general irritation, thus materially augmenting the chance of reduction; and 2, should it be finally necessary to have recourse to the operation, this treatment will place the patient in the condition the most favourable for its performance, more or less anticipating and preventing the constitutional disturbance which would be liable to occur.
1968. In Intussusception of the Bowels, Opium, as in the last section, should have the preference over almost even* other remedy. Cases, illustrative of its successful employment, are recorded; and certainly, both reason and experience would lead us to expect the best results from its use. It may be given in liberal doses, by mouth, and in the form of enema, until the patient is fully narcotised. Purgatives should be avoided, as only tending to increase the already existing mischief,
1969. In obstinate Constipation, which has resisted the previous employment of powerful cathartics, Mr. Wells strongly advises repeated doses of Opium, combined with Calomel. Even if inflammation be totally absent, the best effects may be expected from this combination. The Opium soothes the bowels already irritated by repeated cathartics, allays the over-excited peristaltic action, relaxes any contingent spasm, and quiets the patient's mind. At the same time, the Calomel, by improving the secretions and exciting the action of the liver, tends to remove the cause of the obstruction. No solid, irritating food should be taken, but beef-tea enemas may be employed. The advantages of Opium, compared with the use of purgatives, in severe cases of Obstruction of the Bowels, are insisted upon with much force by Dr. G. Evans.*
* On Diseases of Abdominal Viscera, p. 150, et seq.
Dict Pract. Med., vol i. p. 373.
Surgical Experience of Chloroform, Edin. 1848.
§ Lond. and Edin. Journ. of Med. Science, July 1842.
|| Ibid., Sept. 1841. ¶ Prov. Journ., April 21,1847, and May 30, 1847. ** Ibid., June 16, 1847. Med Times, Aug. 24, 1850. Med. Gaz., Nov. 22, 1850.