Strong soups, rich made dishes of any kind, hot bread or biscuits,
preserved fish or meats, curries, red meats, eggs, fats, butter, sugar,
herrings, eels, salmon, mackerel, sweets, creams, cheese, dried fruits,
nuts, pies, pastry, cakes, malt liquors, sweet wines, champagne.
ACUTE GENERAL PERITONITIS. (Inflammation of the Peritoneum, Lining of the
Abdominal Cavity).--Causes. Primary; Occurs without any known preceding
disease, and is rare. Secondary; Occurs from injuries, extension from
inflamed nearby organs, such as appendicitis or infection from bacteria,
without any apparent lesion (disease of the bowel). Perforation causes
most of the attacks of peritonitis. Peritonitis may accompany acute
infections or accompany chronic nephritis, rheumatism, pleurisy,
tuberculosis and septicemia. Peritonitis occurs from perforation of the
bowel in typhoid fever also, and it frequently occurs after appendicitis
and sometimes after confinement.
Symptoms.--This is often the history of one of the causes mentioned above,
followed in cases with perforation or septic disease by a chill or chilly
feeling and pain, varying at first, with the place where the inflammation
begins. The patient lies on his back, with the knees drawn up, and the
body bent so as to relax the muscles of the abdomen, which are often
rigidly contracted,--stiff at first on the side where the pain starts. The
pain may be absent. The abdomen becomes distended, tympanitic (caused by
gas). An early symptom is vomiting and it is often repeated. There is
constipation; occasionally diarrhea occurs. The temperature may rise
rapidly to 104 or 105 and then become lower; it is sometimes normal. The
pulse is frequent, small, wiry and beats 100 to 150 per minute; the
breathing is frequent and shallow. The tongue becomes red and dry and
cracked. Passing the urine frequently causes pain; sometimes there is
retention of urine. The face looks pinched, the eyes are sunken, the
expression is anxious, and the skin of the face is lead colored or livid.
Hiccoughs, muttering, delirium or stupor may be present.
[134 MOTHERS' REMEDIES]
Recovery, Prognosis, etc.--The action of the heart becomes weak and
irregular, respiration is shallow, the temperature taken in the rectum is
high, the skin is cold, pale and livid, death occurs sometimes suddenly,
usually in three to five days; less often thirty-six to forty-eight hours;
or even after ten days. The results depend mainly upon the cause of the
inflammation, and the nature of the infection, infectious disease that
produces it, being usually very bad after puerperal sepsis (after
confinement), induced abortion, perforation of the bowel or stomach, or
rupture of an abscess.
LOCAL PERITONITIS.--This may come from local injury, but it is usually
secondary to empyema, tuberculosis, or cancer, abscess, perforation of the
stomach or bowel, ulcer, etc.
Symptoms.--Onset is usually sudden. There is sudden local pain, increased
by any movements; tenderness, and vomiting; then chills, irregular fever,
sweating, difficult breathing, emaciation.
TREATMENT OF THE ACUTE PERITONITIS.--There must be absolute rest, morphine
by hypodermic method, one-fourth to one-half grain to relieve the pain.
Ice cold and hot fomentations with some herb remedy like hops, smartweed,
etc.; or cloths wrung out of hot water with five to ten drops of
turpentine sprinkled on them. This is very good when there is much
bloating from gas.
The turpentine should be stopped when the skin shows red from it. The
cloths should not be heavy or they will cause pain by their weight. Ice
water can be used when cold cloths are needed.
For vomiting.--Stop all food and drink for the time and give cracked ice.
Diet.--Should be hot or cold milk with lime water or peptonized milk if
necessary. If the feeding causes vomiting, you must give food by the
rectum. For the severe bloating enemas containing turpentine should be
given, one to two to six ounces of water used with ten to thirty drops of
turpentine in it; sometimes it is necessary to resort to surgery.
TUBERCULAR PERITONITIS.--This may occur as a primary trouble or secondary
to tuberculosis of the bowels, lungs, and Fallopian tube. It is most
frequent in males between twenty and forty.
[ DIGESTIVE ORGANS 135]
Symptoms.--These are variable. It may occur like acute peritonitis with
sudden onset of high fever, pain, tenderness, bloating, vomiting and
constipation; these symptoms passing into those of chronic peritonitis.
Often there are gradual loss of strength and flesh, low and irregular
fever; frequently the temperature goes below normal with a little ascites
tympanites, constipation, diarrhea and masses in the abdomen which consist
of the omentum (apron covering the bowels) rolled up and matted into a
sausage-shaped tumor in the upper part of the abdomen, or of thickened or
adherent coils of the bowel, enlarged mesentric lymph nodes, etc.
Spontaneous recovery may occur, or the course of the disease may resemble
that of a malignant tumor.
Treatment.--If there is effusion and few adhesions, cutting in and
removing the fluid may help. In other cases good nourishing diet with cod
liver oil is best.
ASCITES. (Hydroperitoneum. Abdominal Dropsy).--This is an accumulation of
serous fluid in the peritoneal cavity. It is but a symptom of disease.
Local Causes.--Chronic peritonitis, obstruction of the portal (vein)
circulation as in cirrhosis of the liver, cancer or other liver disease,
from heart disease, tumors, as of the ovaries or enlarged spleen. All
these mentioned may produce this dropsy.
General Cause.--Heart disease, chronic nephritis, chronic malaria, cancer,
syphilis, etc.
Symptoms.--Gradual increasing distention of the abdomen, causing sometimes
a sense of weight, then difficulty of breathing from pressure. The abdomen
is distended, flattened at the sides unless it is very full. The skin may
be stretched tense, superficial veins are distended. The navel may be flat
or even protrude and around it the vessels may be greatly enlarged. There
is fluctuation when you tap sharply at one side, while holding your hand
on the other side you feel a wavy feeling.
PHYSICIANS' TREATMENT for Ascites.--First treat the disease causing it.
Sometimes it is necessary in order to prolong life to repeatedly tap the
patient as in cirrhosis of the liver. When it is caused by the heart or
kidneys, give cathartics that carry away much liquid, hydragogue
cathartics. One dram of jalap at night followed by a big dose of salts
before breakfast. Cream of tartar and salts are good, equal parts. Or
cream of tartar alone, one to two drams, with lemon juice in water in
repeated doses. Digitalis and squill, of each one grain to cause great
flow of urine. Infusion of digitalis is also good to increase flow of
urine, when the heart is the real cause of the ascites. These treatments
take the liquids away through the proper channels, the bowels and kidneys.
[136 MOTHERS' REMEDIES]
Ascites caused by an Ovarian Tumor.--The tumor must be removed. I am not
in favor of indiscriminate operating, but operations often save lives. I
remember one case in which I very strongly urged the lady to have an
operation performed. It was a case of ascites, caused, as I was sure, by a
tumor of the ovary. The lady, as almost all people do,--and I do not blame
them for it,--dreaded even the thought of an operation, but she was
finally compelled to have an operation or die. She filled so full that it
was almost impossible for her to breathe. She went away from home in
terrible shape, almost out of breath, and returned home a well woman and
has remained so. Such cases formerly died. But not all cases of ascites
can be cured by an operation, it depends upon the cause. In many cases all
one can do is to doctor the cause, if that cannot be removed, make the
patient's remaining days as comfortable as possible.
DISEASES OF THE RECTUM AND ANUS.--The lower part of the alimentary canal
is called the rectum, originally meaning straight. It is not straight in
the human animal. It is six to eight inches long. The anus is the lower
opening of the rectum. In health it is closed by the external Sphincter
(closing muscle). Disease may wear this muscle out and then the anus
remains open, causing the contents of the bowel to move involuntary.
CONSTIPATION. Causes.--1. Mechanical obstruction.