=Osteopathic Etiology.=—An obstructed circulation of the blood through
the venaporta, as in diseases of the heart, lungs and liver; lesions of
the vertebræ deranging spinal nerves to the intestinal blood supply;
injuries caused by corroding or cutting substances; mechanical injuries
to the intestines; degeneration or erosions of the blood-vessels from
ulcers of the intestines, as from typhoid fever, typhus, dysentery,
etc.; disordered menstrual or hemorrhoidal discharges.
=Diagnosis.=—The locality of the intestines affected can be
approximately determined by an examination of the discharged blood.
When the blood comes from the upper part of the intestines, it is
generally dark and mixed with the intestinal contents, which gives it
a tarry appearance. It is generally red and fluid when it comes from
the lower portion of the bowels. If from the stomach, the blood is
thoroughly mixed with fecal matter. Throwing the passage into water,
the water is colored red when it contains blood, and if the contents
contain bile the water is colored green or yellow. Also, noting the
areas of contracted muscles, as in intestinal colic, will aid in the
regional diagnosis.
=Treatment.=—Absolute rest in all cases is necessary, the patient
remaining as quiet as possible. Food, in severe cases, should not be
given for ten or twelve hours. The bed-pan should be used in caring for
the evacuations. Correction of the lesions along the spinal region,
chiefly of the lower dorsal and lumbar regions, that are impeding the
innervation to the intestines, should be attended to at once. This
treatment tends to relieve any hyperemic condition of the intestinal
mucosa and influences the whole vasomotor area of the mesentery. Direct
treatment of the abdomen in a few cases is of great value to relieve
obstructed and contracted vessels in the mesentery, but in certain
pathological conditions, e. g., typhoid fever, leave the abdomen alone.
Treatment (inhibition) along the spinal column from the sixth dorsal
to the coccyx is helpful in all cases to quiet the peristalsis of the
intestines. In severe cases cold drinks, eating of ice and an ice pack
to the abdomen are of aid. In a few instances surgical measures will be
necessary.