(From colon, the name of one of the intestines). The colic; sometimes calledrachial-gia; but this term is more particularly confined to the colica pictonum, the second species.
The appellation of colic is commonly given to all pains of the abdomen, almost indiscriminately; but from the different causes and circumstances of this disorder, it is differently denominated, and some difference in the mode of cure is also to be observed in different cases.
When the pain is accompanied with a vomiting of bile, or with obstinate costiveness, it is called a bilious colic; if flatus causes the pain, that is, if attended with temporary distention,relieved by the discharge of wind, it takes the name of flatulent or windy colic; when accompanied with symptoms of heat and inflammation, it takes the name of inflammatory colic, or enteritis. The different kinds seem to be properly included, under the distinctions of inflammatory, spasmodic, and flatulent colic.
The inflammatory is when actual inflammation seizes some part of the intestinal canal; the disorder will then be considered and treated as an inflammation of the respective part. See Inflammatio ventriculi and in Testinorum.
The spasmodic is when pain affects the belly principally about the navel, attended with an obstinate costiveness, and either a nausea, or actual vomiting. In the beginning it is without inflammation, though inflammation is often a consequence.
Dr. Cullen places this genus of disease in the class neuroses, and order spasmi; and defines it, pain of the abdomen, particularly round the umbilicus, attended with vomiting and costiveness. He enumerates seven species.
1. Colica spasmodica, with retraction of the navel; and spasm of the muscles of the belly.
2. Colica pictonum, called also rachialgia pictonum; metallica; traumatica. It is also called bellon, when produced by lead. Beasts and poultry, as well as men, are subject to it, if in the vicinity of smelting houses. The symptoms of this species in men are a sense of weight or uneasiness, first affecting the abdomen, particularly round the navel; succeeded by pain, in the beginning slight, not continued, and increased especially after eating: at length the pain is more violent, and remains almost constant, terminating in paralysis.
3. Colica stercoraria, which happens from obstinate and long continued costiveness.
4. Colica accidentalis, called also cholera sicca, from acrid undigested matters.
5. Colica meconialis, in infants, from a retention of meconium.
6. Colica callosa, from a sensation of a stricture in some part of the colon, and frequently of previous flatulence gradually passing off; the habit costive, or faeces liquid, and in small quantity.
7. Colica calculosa, from calculi formed in the intestines, attended with a fixed hardness in some part of the abdomen. It is distinguished by the previous discharge of calculi.
8. Colica flatulenta may be added to these species. It is distinguished by a sudden fulness, with pain and constipation, relieved by a discharge of wind from the mouth or anus.
The early symptoms of the two first species do not greatly differ. A pain, chiefly confined to the umbilicus, with a costiveness, attends both. The difference arises from a more peculiar obstinacy of the bowels in colica pictonum, from its attacking in paroxysms, and from a weakness of the hands soon coming on. It is styled from the place where it is endemial, the Poitou, the Surinam, the Devonshire colic; from its victims, the plumbers and the painters colic; from its symptoms, the dry belly ach, the nervous and spasmodic colic. It has been attributed to the poison of lead; and this is undoubtedly the cause, when it occurs to glaziers, painters, and those employed in lead works; but though this is one, it is by no means the only, cause. In Devonshire it certainly more often arises from the early cyder, made of harsh, unripe fruit, and in the West Indies from new rum. The whole region of the intestines is the subject of this disorder: in any part of them it may manifest its presence; but in whatever part the true colic occurs, the pain is usually felt round the navel. The real spasm is often very distant. If the lower part of the colon, or the intestinum rectum, is affected, the colon in the left hypochondrium, towards the spleen, together with that part of it which is seated beneath the stomach, and near the liver, become greatly inflated. When, as it often happens in hypochondriac and hysteric disorders, the beginning of the jejunum, or the end of the duodenum, is spasmodically affected, a severe pain in the loins, on account of the superior mesenteric and intercostal branch of the nerves, which spread themselves on the jejunum, conies on; but more probably from the attachment of the mesentery. In this case the duodenum and stomach are inflated, the breathing is considerably affected, and great anxiety follows.
Spasms may be excited by extraordinary agitations or uneasiness of mind; or by acrid and stimulating matter thrown upon the bowels. Bile, and other excre-mentitious sordes, may be too long retained, or change their milder qualities; acrid substances may be swallowed, or conveyed to the intestines by other means; particularly lead from vapours, as well as its solutions in different ways. This cause is, however, comparatively very uncommon. Gouty matter diverted from its original seat to the intestines, worms, obstructed periodical evacuations, may have a similar effect.
Whatever be the cause, the approach and progress of this disorder are nearly the same. It begins with a sense of weight, or pain, at the pit of the stomach, attended with loss of appetite, yellowness in the countenance, a slight sickness, and costiveness; the pain gradually increases, no longer wanders, but becomes fixed about the navel, from whence painful dartings proceed in various directions; wherever pain is felt, a soreness and tenderness remain some time afterwards. The sickness increases with the pain, and, at length, a vomiting of bilious matter comes on; the urine is diminished in its usual quantity, and a tenesmus sometimes adds to the distress. While the pain is spasmodic, the pulse remains unaffected, except concurring circumstances produce a change in it; the urine is various; if the smaller intestines are the seat of the pain, it is felt more acutely; if the larger intestines are the parts aggrieved, the sense of pain is more dull and heavy; sometimes there is a bitter taste in the mouth, and a yellowness in the countenance: if the symptoms are not relieved, an inflammation or a gangrene may ensue; or the excrements returning, are ejected by vomit, and death soon follows.