Acute Inflammation of the Bowels. Enteritis.
By inflammation of the bowels is generally understood an inflamed condition of the mucous membrane which lines them; but this, most commonly, is only a part of the disease; it involves more or less, besides this mucous lining, the whole substance of the bowel. After an inflammation has existed some time, and even, in severe cases, at the start, certain poisonous substances are formed as the result of germ invasion, called toxins. These are genuine poisons, and often spread rapidly through the wars of the bowels by means of the numerous lymphatic vessels to the peritoneum itself, that delicate membrane which we have seen covers all organs within the abdominal cavity. When this membrane once becomes poisoned, an acute inflammation sets up, which masks all other symptoms, and is indeed a veritable blood poison. We have then to deal with peritonitis.
Symptoms. The disease begins with a chill and with uneasiness and slight griping pains, which increase in severity until they are intense and burning. Pressure aggravates the pain, which is most intense about the navel, but extends more or less over the whole bowels.
From the beginning there is sickness at the stomach, and sometimes vomiting; there is loss of strength, costiveness, great anxiety, thirst, heat and fever, dry, furred, and red tongue, and but little urine, with pain in passing it. The matters passed from the bowels axe dark and fetid; and the whole belly is tender and sore to the touch. The pulse is quick, hard, and small.
The stomach will be but little affected, comparatively, when the disease is at some distance from it in the lower portion of the bowels. Indeed, the nearness of the inflammation to the stomach, or its remoteness from it, may be judged pretty correctly by the degree of disturbance in that organ. The length of time after drink and medicines are swallowed, before they are vomited up, is a pretty good measure, likewise of the distance of the disease from the stomach.
How to Discriminate. This disease is liable to be confounded with colic, and with inflammation of the peritoneum. It is important to distinguish it from colic, particularly, because the treatment for that would aggravate this. In this disease the pain is increased by pressure; in colic, it is not, but is rather relieved. In enteritis, the pain remits, but never ceases wholly, as it does in colic. In enteritis, the knees are drawn up, and the breathing is short; in colic it sometimes gives relief to stretch the feet down, and the breathing is not altered.
To distinguish it from inflammation of the peritoneum, take notice that diarrhea is much more common than in this latter complaint, while the pulse is not as quick, nor the pain as severe.
Treatment. This should be very much the same as that recommended for peritonitis.
The tincture of veratrum viride, in full doses, so as to keep up a free perspiration, cold compresses, mustard poultices, hot f fomentations, poultices, blisters, soothing and quieting injections, and demulcent drinks, as slippery elm, marshmallow, flaxseed, etc., if judiciously applied, will do about all that we have it in our power to accomplish.
In this disease it is well to inquire ff the patient has a hernia, for if so, it is liable to become strangulated without his knowledge. A strangulation of the gut may be the cause of the disease. When this happens, the complaint is very 'unmanageable. Here again magnesia may be of signal benefit unless the movements are already too copious and exhausting, in which case disinfectants or astringents must be resorted to, The possibility of tuberculosis must not be ignored,
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