Contributions to practical medicine / by James Sawyer.

  • Sawyer, James, Sir, 1844-1920.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to practical medicine / by James Sawyer. Source: Wellcome Collection.

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    or that some part of the intestine is pouched and liable to twist. If, in the early part of a case, the abdomen become distended and hard, it is almost certain that there is peritonitis. If the intestines continue to roll about visibly, it is almost certain that there is no peritonitis. This symptom occurs chiefly in emaciated subjects, with obstruction in the colon of long duration. The tendency to vomit will usually be relative to three conditions, and proportionate to them. These are, (1) the nearness of the impediment to the stomach; (2) the tightness of the constriction; and (3) the persistence or otherwise with which food and medicine have been given by the mouth.”* No clinical spectacle is more terrible than that afforded by a case of acute and complete intestinal obstruction. All of us, probably, have seen some examples of it. In the midst of perfect health, without obvious cause or warning, or after some unusual and sudden muscular effort, or after a blow on the belly, or after a trifling diarrhoea or some slight constipation, or following some ordinarily insigniflcant error of diet, a vigorous adult is seized witli severe pains in the abdomen. The pains are mostly griping and colicky in character, they usually come and go at short intervals, and they are usually referred to the * Notes on Intestinal Obstruction. By Jonathan Hutchinson, F.R.O.S. llritish Medical Journal, August 31, 1878.