On intestinal concretions / by Patrick Henry Watson.

  • Watson, Patrick Heron, 1832-1907.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: On intestinal concretions / by Patrick Henry Watson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    posed of hardened fasces. As this was manifestly the obstacle which prevented the escape of urine and the introduction of the catheter, I determined, with the approval of Dr Husband, to break it down and extract it from the bowel. I effected this, after much labour, by means of the handle of an iron spoon, and now found the catheter could be introduced into the bladder without difficulty. On examin- ing the broken-down mass which formed the ball, I found it was in great part composed of hardened faeces, combined with which there was intermixed a quantity of fibrous substance like tow. There was however no manifest calcareous coating to any portion of the mass. But in the operation of breaking down, the shank of the metal spoon seemed constantly to grate against calcareous particles mixed with the general mass. This patient had long suffered from constipation of the bowels, but for some years past had experienced alternating attacks of constipation and diarrhoea of a dysenteric type, or with symptoms of proctitis. I could obtain no history to account for the fibrous substance in the fteculent mass. The patient had never swallowed such material intentionally, nor had it ever been inserted into the anus as a plug to check a troublesome diarrhoea, a plan I have known resorted to among soldiers.1 To explain the existence of the felt-like residuum of the calculus which has been so constantly observed in cases of regular bezoars, or enteroliths, need occasion no difficulty in those instances where hairs, capable of being formed into felt, compose the mass of the concretion. The difficulty has chiefly existed to explain the accumu- lation of such delicate fibres and hairs as those met with in the vegetable kingdom, which are not specially endowed with fine processes projecting from the surface, on which the facility in producing felt with the hair of rabbits and hares is now known to depend. This difficulty will, however, be removed when we consider the following facts:—(1.) That in the drain-pipes of domestic houses obstructions are constantly produced by masses or balls of human hair, which have apparently accumulated from the combings of hair - brushes. (2.) Marine tegagropiles are ap- parently formed by the rolling motion of the waves, weaving together into ball-like masses the fibres of marine plants subjected to their action. (3.) Similarly, in our own country, the needle- like leaves of the larch dropping into fresh-water, are susceptible of being moulded into these singular balls, composed of woody fibre, resembling the fir-wool, or brownish cottony substance em- ployed in some parts of Germany for the manufacture of textile fabrics. (4.) Clay balls are frequently met with in the interior of the common garden roller, and may even contain a nucleus which rattles within the dry outer layers when the mass i3 shaken.2 The different appearances presented by the enteroliths, are ] M'Lauchlan, London Medical Gazette, vol. xxix., p. 846, 1842. 2 This last fact was mentioned and illustrated by examples by Dr George W. Balfour at the meeting of the Edinburgh Medico-Chirurgical Society, 5th February 1868.