(From Ma. the small guts). The iliac passion, ileus, convolvulus, contorsio, cileos, chordapsus,volvulus, tormentum; a disease of the small intestines, generally from spasm: Dr. Cullen considers it synonymous with colica.
Considerable confusion has prevailed in describing the symptoms and cure of iliac passion, from inflammation being often attended with spasm, in consequence of increased sensibility and irritability; as well as from spasm producing inflammation. We shall, in considering this complaint, distinguish it wholly as a spasmodic disease, referring the inflammatory ileus to its proper head, under Inflammation.
The disease is characterised by a violent pain in the abdomen, with an inversion of the peristaltic motion of the bowels, so that their contents are thrown up by vomiting. It is usually an acute disorder, but not essentially inflammatory. We know only of three species. The first consists of spasm from causes of debility. These are, gout, repelled eruptions, narcotic passions, particularly of lead, and the vegetable narcotics. In this case the disease is nearly in cause and cure the same with Colica pictonum, q. v.
The second species is produced by an introsuscep-tion of the intestine, where a portion of the intestine" falls down into the part below, generally doubling the intestine for the space of an inch or more, and thus constricting it. This is occasioned often by spasm, which contracting the diameter of a part of the gut admits of its introduction into that below. To this species the term of the true iliac passion is sometimes confined. Dr. Hunter takes notice of a disease to which children are more particularly subject, because their mesentery, having scarce any fat upon it, easily slips with the gut; and this he calls the volvulus, or volvulus, of which he observes there are two kinds: the first is when a part of a gut is received into the part next above it; the other is when a part of the gut is received into that below it. The last is, however, by far the most frequent.
The third species is a spasm of the intestines, excited by a mechanical body irritating or obstructing the intestines. A plumb stone or a calculus is of this kind; but the intestinal calculus is very rare in the human species. It will be obvious, however, that the first and third of these species properly belong to colica; nor indeed is it easy to separate these diseases. Much confusion would be avoided by abolishing the term altogether, or by confining it wholly to colic from introsuscep-tion. The latter, however, is seldom known till death, and cannot properly form a distinct disease.
A costiveness usually precedes this disorder for some days, and pain is chiefly felt about the navel. With the pains, the belly is gradually inflated, and a hard tumour is felt in the umbilical region, surrounding the belly like a cord: not the least flatulence can for a time pass either upward or downwards. Inflammation, with its worst consequences, rapidly comes on.
The iliac passion should be distinguished from rheumatic pains in the muscles of the abdomen, and from inflammation of the peritoneum. In the first the external soreness is considerable, and the pain in mo-the body much greater than in colic, even when inflammation has come on. The same circumstances distinguish peritonitis, and in both free motions do not cure considerable relief.
The cure of iliac passion differs in no respect from that of colic. If it arises from introsusception, we have said that it is seldom known. Practical authors have remarked, that if the gut has fallen into the intestine below, laxatives are injurious, and the cure must be attempted by clysters. The contrary practice is preferred in opposite circumstances. This is, however, a refinement which we cannot apply, as the existence of either is unknown.
Clysters of the fumes of tobacco will, in this species of disease, be particularly useful; and the warm bath is frequently salutary. A blister also to the abdomen, a remedy particularly adapted to Inflam-matio intestinorum, q. v. is often useful in this disease.
The prognostics are favourable while inflammation is absent; while clysters can be thrown up, and returned by stool; while the pains shift, and the pain and vomiting occur only at intervals: it is still more promising, if a laxative, taken by the mouth, passes by the anus; but if little or no relief is obtained by stool for some days there is scarcely room for hope - indeed none, unless true feculent matter is copiously discharged. An entire suppression of urine is a dangerous symptom, though some degree of suppression generally attends.
Sec Hippocrates de Morbis; Aretaeus; Ccelius Au-relianus; Celsus; F. Hoffman; Sydenham; London Medical Observations and Inquiries, vol. i. p. 223, Etc.; Edinburgh Medical Commentaries, vol. ix. p. 266, 278.
Iliaca minor, ahteria, is the most posterior branch of the hypogastric artery; sometimes the branch of the glutae.