5. Abnormal contents.--Fruit stones, coins, pins, needles, false teeth,
round worms rolled in a mass. Coins rarely cause inconvenience.
[122 MOTHERS' REMEDIES]
Symptoms of Acute Obstruction.--Constipation, pain in the bowels, and
vomiting are the three most important symptoms. Pain sets in early, and
may come on abruptly when walking or more commonly when working. It is at
first colicky, but soon becomes continuous and very intense, vomiting soon
follows and is constant and very distressing. First the stomach contents
are vomited, and the greenish bile-stained material, and soon the material
vomited is a brownish-black liquid, with a bowel odor. This peculiar
vomiting is a very characteristic symptom. Constipation may be absolute,
without the discharge of either feces or gas. Very often the contents of
the bowel below the obstruction are discharged. The abdomen is usually
distended and when the large bowel is involved this is extreme. If it is
high up in the small intestine, it may be very slight. At first, the
abdomen is not tender, but later it becomes very sensitive and tender. The
face is pale and anxious and finally collapse symptoms intervene. The eyes
are sunken, the features look pinched and a cold, clammy sweat covers the
skin. The pulse becomes rapid and weak. There may be no fever, and it may
go below normal. The tongue is dry, parched, and the thirst is incessant.
Recovery.--The case terminates as a rule in death in three to six days,
if aid is not given.
Treatment.--Purgatives should not be given. For the pain, hypodermics of
morphine are needed. Wash out the stomach for distressing vomiting. This
can be done three to four times a day. Thorough washing out of the large
bowel with injections should be practised, the warm water being allowed to
flow in from a fountain syringe and the amount carefully estimated.
Hutchinson recommends that the patient be placed under an anesthetic, the
abdomen kneaded, and a copious enema given with the hips placed high or
patient in inverted position. Then the patient should be thoroughly
shaken, first with the abdomen held downward and subsequently in the
inverted position. If this and similar measures do not succeed by the
third day surgical measures must be resorted to.
For bloating, turpentine cloths should be used, and other hot, moist
applications.
Diet.--Should be very light, if any, for a day or so.
RUPTURE (Hernia).--Hernia means a protrusion of an organ from its natural
cavity, through normal or artificial openings in the surrounding
structures. But by the term hernia, used alone, we mean the protrusion of
a portion of the abdominal contents through the walls, and that is known
by the popular term of "rupture."
[DIGESTIVE ORGANS 123]
The most common forms of rupture protrude through one of the natural
openings or weak spots in the abdominal walls, as for instance, the
inguinal (groin) and femoral canals. The femoral canal is located at the
upper and inner part of the thigh, and this place is a seat of rupture,
especially in women. Rupture may also occur at the navel, when it is
called umbilical hernia or rupture. The contents of a hernia are bowel and
omentum (a covering of the bowel) separately or together. The bowel
involved in a rupture is usually the lower portion of the small bowel, but
the large bowel is sometimes affected. A sac covers the bowel or omentum
in a rupture. This sac consists of the protruded portion of peritoneum,
which has been gradually pushed through one of the canals (inguinal or
femoral) or of the process of peritoneum, which has been carried down by
the testicle in its descent, and the connection of which with the
peritoneum of the abdomen still continues, not having been obliterated, as
it usually is before birth. The former is called an acquired rupture sac;
the latter is a congenital rupture sac, and it is found only in groin
(inguinal rupture).
Causes.--Rupture is more common in men than in women. It may occur at any
time of life. The majority of cases occur before middle age, and the
largest number during the first ten years of life, owing to the want of
closure of the peritoneum which is carried down by the testicles before
birth. Rupture is most frequently strangulated between the ages of forty
and fifty.
Location.--The great majority of cases of rupture are groin or inguinal
rupture.
Symptoms.--A fullness or a swelling is first noticed in the groin, which
is made worse in standing, coughing and lifting. This disappears on lying
down and reappears on rising in many cases, even at first; coughing makes
the lump or swelling harder. It may come on both sides, when it is called
double rupture or hernia.
MOTHERS' REMEDIES.--Rupture, Poultice for.--"Take equal parts of lobelia
and stramonium leaves; make a poultice and apply to the parts. Renew as
often as necessary. This combination makes a very effective poultice and
is sure to give relief."
PHYSICIANS' TREATMENT.--A person should wear a truss (support) that fits
perfectly, and this should not cause any pain or discomfort. The truss
should be worn all day, taken off at night after going to bed and put on
before rising, when still lying down. If it is put on after rising a
little of the gut may be in the canal and pressed down by the support.
There are many kinds of supports.
Operations now performed for rupture are very successful if the patient
takes good care for months afterwards until the parts are thoroughly
healed. The operation simply closes a too large opening. The testicles
descending through the groin canal from the abdominal cavity before birth
and in congenital rupture, left too big an opening. In acquired rupture,
these natural openings were enlarged by lifting, falls, etc. The round
ligament of the womb goes down through this canal and sometimes there is
too large an opening left or acquired by accident.
Irreducible Rupture.--This is when the rupture cannot be returned into
the abdominal cavity, and it is without any symptoms of strangulation.
They are of long standing and of a large size. This condition is often due
to carelessness of a patient in not keeping in a reducible rupture with a
proper support. Adhesions form, holding the rupture. Even if it is small,
it gives rise to much discomfort and the patient is always in danger of
strangulation of the rupture.
Operation for radical cure is generally a success.
[124 MOTHERS' REMEDIES]
Strangulation Hernia or Rupture.--This means the rupture is so tightly
constricted that it cannot be returned into the abdominal cavity, and its
circulation is interfered with; then there is not only obstruction to the
passage of the feces, but also an arrest of circulation in the protruded
portion of bowel which, if not relieved, results in gangrene and death.
This occurs more often in old than in recent ruptures and more often in
congenital than in acquired rupture.
Symptoms.--Sudden and complete constipation with persistent vomiting. The
lump may be tense, hard and irreducible. Then there is faintness,
collapse; severe abdominal pain, complete constipation, with no gas
passing, then vomiting, at first of food, then of the bile-stained fluid
and finally of fluid with a bowel odor. All these symptoms increase and
the patient gradually sinks from exhaustion in eight or nine days, though
in very acute cases the patient may die within forty-eight hours.
MOTHERS' REMEDIES.--Strangulated Hernia, Hop Poultice for.--"A large warm
poultice of hops over the abdomen will be found one of the best known
means of relieving strangulated hernia."
PHYSICIANS' TREATMENT.--It must be reduced or an operation must be
performed and soon.
To reduce.--The patient is put under an anesthetic and placed on his back
with the hips (pelvis) raised and the thigh of the affected side flexed,
bent up and rotated inward if the rupture be inguinal or femoral. This
motion relaxes the parts. The neck of the sac is then seized with the
thumb and fingers of one hand, and thus fixed, while with the other hand,
the operator endeavors to return the strangulated gut by gentle pressure
in the proper direction. In femoral rupture, this is at first downward, to
bring the gut opposite the opening then backward and then upward. In groin
(inguinal) rupture it is usually slightly upward and outward. It must be
coaxed, kneaded and squeezed carefully. Care must be taken. If it cannot
be returned in from five to ten minutes no further time should be wasted,
but an operation should be performed immediately. This consists in cutting
down to the constriction and through it, thus allowing the rupture to be
reduced.
The patient should be kept in bed and treated the same way as for other
abdominal operations.
Caution.--Persons with rupture must be very careful not to lift or fall.
If a support is worn it must fit perfectly and be worn with comfort.
[DIGESTIVE ORGANS 125]
INTESTINAL COLIC. (Enteralgia).--Causes.--Predisposing; poor general
condition, worry, over-work, nervous disposition. Exciting causes;
exposure, gas in the bowels, mass of feces, undigested or irritating food,
cold drinks, green fruit, ice cream when a person is very warm.
Symptoms.--Intermittent pain usually in the umbilical (navel) region,
moving from place to place, dull or sharp pain, relieved by pressure or
bending forward. Abdomen is distended or drawn back. It lasts a few
minutes or many hours, ending gradually or suddenly, after a passage of
gas or movement of the bowels.
PHYSICIANS' TREATMENT.--1. Remove cause first if possible. Mild cases; put
heat to the abdomen by hot water bag, wring cloths out of hot water and
put in them ten drops of turpentine and place over the bowels hot. Give
dose of peppermint water or ginger tea.
2. Severe case.--Morphine hypodermically, if necessary, in a severe case;
mustard poultice is good, also a spice poultice.
3. Tincture of Colocynth (bitter cucumber) is an excellent remedy for this
trouble. I have often used it with great success. Put five drops of it in
a glass half full of water and give two teaspoonfuls every fifteen minutes
until relieved. A few doses generally relieve the patient.
THE LIVER.--The liver is the largest gland in the body, and is situated in
the upper and right part of the abdominal cavity. The lower border of the
liver corresponds to the lower border of the ribs in front and to the
right side. It weighs fifty to sixty ounces in the male; in the female,
forty to fifty ounces. It is about eight to nine inches in its transverse
measurement; vertically near its right surface it is six to seven inches,
while it is four to five inches thick at its thickest part. Opposite the
backbone from behind forward it measures about three inches. The left
lobe, the smallest and thinnest, extends to the left, over what is called
the pit of the stomach.
BILIOUSNESS.--This condition presents different symptoms in different
cases, but it always includes languor, headache or dizziness, perhaps some
yellow color of the skin and conjunctiva, and a general sense of want of
tone, depression of spirits and discomfort.
Causes.--The liver does not perform its function well, or there is a
retention of bile in the bile ducts. Most of the symptoms do not depend
directly upon the changes in the bile, but upon failure of proper
digestion in the stomach and intestines. Certain poorly prepared foods or
improper food for stomach digestion, quickly cause the development of
active fermentation and its results irritate the stomach mucous membrane
bringing about a faulty stomach secretion of mucus, which causes further
trouble. It may end in a sick headache.
TREATMENT. Prevention.--Normal, easily digested food, open bowels. Active
exercise, horseback riding, massage of the liver region. Stooping over and
bending from side to side and bending back with feet close together are
good aids.
[126 MOTHERS' REMEDIES]
Diet.--Do not over-eat. Avoid alcohol in any form. Stimulating foods such
as spices, mustard salads, concentrated meat extracts and meat broths,
pepper, horseradish are not to be used. Do not use too much salt; strong
coffee and tea are harmful. In severe cases milk either diluted with water
or lime water or peptonized should alone be used.
Gruels, albumen water, kumiss, buttermilk and oyster broth may be allowed.
Orange juice as well as lemonade may generally be given. Fasting is good
in biliousness. No one will starve in a few days of fasting.
MOTHERS' REMEDIES.--1. Biliousness, Lemons for.--"One lemon squeezed in a
glass of water with a very little sugar, repeat for several days." Lemon
is a very good medicine, and it is surprising to know how few people
realize what medical properties the lemon contains. This is a good,
simple, but very effective remedy.
2. Biliousness, Salt and Water for.--"Take a teaspoonful of salt to a cup
of water and drink before breakfast for a few mornings." It is a
well-known fact that a little salt in warm water before breakfast is
laxative and also cleanses the system and bowels on account of its
purifying action.
3. Biliousness, (chronic) Dandelion Tea for.--"Dandelion root is highly
recommended for this." The root should be collected in July, August or
September. Dose:--A strong tea may be taken freely two or three times a
day, or the fluid extract may be purchased at any drug store.
4. Biliousness, a cheap and very safe plan.--"Drink plenty of cold water
and exercise freely in the open air." Following the above advice is often
better than medicines and spring tonics, also unless doing hard physical
labor, cut down on the meat eating. In fact, eat less generally for a
time.
5. Biliousness, Salt Lemonade for.--"Hot salt lemonade night and morning.
Juice of one lemon and teaspoonful salt to as much hot water as you can
drink."
6. Biliousness, Boneset Tea for.--"Pour hot water on boneset and let stand
until it is cold. Take a swallow occasionally." This is very good.
PHYSICIANS' TREATMENT. Medicines.--1. Nitro-hydrochloric acid three drops
three times a day in half a tumblerful of water is valuable.