Charles Gottleib Raue.

Special pathology and diagnostics : with therapeutic hints online

. (page 31 of 65)
Online LibraryCharles Gottleib RaueSpecial pathology and diagnostics : with therapeutic hints → online text (page 31 of 65)
Font size
QR-code for this ebook


skin, pulse irritated.

Dulc, after taking cold ; the griping is attended with nausea in the
stomach and followed by diarrhoea.

Pulsat., after getting the feet wet.

Rhus tox., after getting wet all over.

Nervous colic is a consequence of morbid innervation arising sud-



298 INTESTINAL CANAL.

denlj, sometimes without any known causes, showing no abnormity
in the abdominal cavity.

Here are indicated :

Colocynthis, after indignation.

BeSladonna, clawing around the navel; better from pressure.

Ignatia, after grief and fright.

Opium, after sudden fright.

Plumbum, contracted abdomen.

Lead colic — poisoning by lead. Bluish-gray line along the gums ;
contracted abdomen ; pain lessened from external pressure ; obstinate
costiveness ; slow pulse.

Antidotes— 0^\wm, Platina, Nux vom., Alumina, Ant. cr., Coco.,
Zinc.

Copper colic — poisoning hy copper. Distended abdomen; pain worse
from slightest touch ; nausea ; vomiting ; tenesmus.
Antidotes. — Hepar, Nux v., Bellad.

All other, secondary forms of colic, are mere attendants upon other
disturbances, which either have been considered already, or will be
considered in the course of our future investigations.

Special Hints.

Aeon,, intolerable, cutting pains in the belly, so violent that he
screams, tosses about, and is almost beside himself; after taking cold.

Alum., lead colic.

Arsen., pains in the whole abdomen, excessive; worse at night, after
eating and drinking ; better from warm application ; with vomiting,
or diarrhoea, or costiveness; great anguish, lamentations, tossing about ;
internal restlessness, which does not allow one to lie still ; despair of
life ; after the use of ice water, ice-cream ; bad sausages, cheese ; lead
poisoning.

Asa f., distention of the abdomen, with severe pain and a feeling as
though something were rising from below upward into the chest and
throat ; during the height of the paroxysm, fainting ; pain better from
external pressure ; in hysteric and hypochondriac persons.

Aurum, painful accumulation of gas below the left ribs, causing a
stitching pain there ; coming on even after eating the simplest food.

Bell., during the pain the transverse colon protrudes like a pad all
the way across the belly ; while sitting or standing and walking, much
worse, with a feeling as though the intestines were loose and dragging
downwards; external pressure and bending double relieves some-



COLIC. 299

what ; protrusion in tlie inguinal region as tliick as a finger, which,
when pressed upon, disappears with a gurgling sound ; pain below the
navel, as though a portion of the intestines were seized with the nails,
clawing it together ; thin purulent stool ; congestion of the head •
copper-colic.

Bryonia, after taking cold ; cutting, lancinating pain in the abdo-
men; worse from motion and drinking cold water; bowels consti-
pated; feces hard, as if burnt; tongue coated, white, dry, without
thirst ; or else great thirst.

Calc. c, severe spasms in the intestines, especially in the evening
and at night, with coldness of the thighs ; feeling of coldness in the
abdomen ; enlargement and hardness of the abdomen, particularly in
teething children ; diarrhoeic, clay-like stools, smelling sour or fetid ;
sweat on the head.

Carbo veg., fulness and distention of the abdomen, with a feeling as
though it would burst ; squeezing and pressing in the left side of the
epigastrium, or in the region of the bladder ; oppression of the chest ;
belching, tasting sour and rancid ; headache ; chilliness over the back ;
hypochondriac mood ; worse from eating, if ever so little ; better from
emission of flatus or hard stool ; colic from riding in carriage.

Caust., crampy colic of a chronic character; pain from the stomach
through to the back, np into the chest, down into the abdomen ; belch-
ing ; rumbling in the bowels ; obstinate constipation ; tongue coated
whitish on both sides.

Cham., flatulent colic ; the abdomen is distended like a drum, or
the wind presses here and there against the abdominal walls, with a
feeling as if it would pierce through ; or the patient has a feeling
as if the whole abdomen were hollow, with continual rolling in the
bowels and blueness around the eyes; or the excessive pain simulates
a sensation as if the parts were rolled up into a ball ; vomiting ; diar-
rhoea, green and slimy ; or continuous, with passing of small quantities
of flatus without relief; great restlessness, anxiety ; sticky or hot per-
spiration ; after chagrin.

China, distention of the abdomen, with pressing under the short
ribs ; rumbling and cutting pain in the bowels ; worse at night ;
brought on by eating fruit or drinking new beer ; after exhausting-
illness, loss of vital fluids, profuse perspiration.

Chinin. sulph., flatulent colic of an intermitting type.

Cocc, flatulent colic, about midnight, with incessant formation of
flatulence, distending the abdomen, going ofi' without relief, and oblig-
ing to turn from side to side ; belching relieves ; the pain is severest



300 INTESTINAL CANAL.

in the epigastric, umbilical and right iliac region ; nausea, vomiting ;
yellow face ; cold perspiration, anxiety and restlessness.

Colchic, great distention of the abdomen ; also when the abdomen
is empty, aggravated by eating ; the stomach feels icy cold ; after flat-
ulent food.

Coloc, aU sorts of violent pains, mostly in the umbilical region, or
from the sides concentrating in the middle ; the patient doubles up,
or seeks relief by pressing the belly against the bed-post or any other
hard object, or in lying on the belly ; likewise a tight cramp-like pain
in the left iliac and inguinal region, which is worse after (not during)
external pressure, especially observed in women after excess in
venere ; after indignation ; abuse of opium ; a cup of coffee generally
relieves the pain for a while.

Cupr., violent spasms in the abdomen and in the upper and lower
limbs, by spells ; cutting pain in umbilical region, as if a knife were
thrust through into the back ; screams as though he were being killed,
throwing himself upon the floor.

Dioscorea, constant dull pain in the epigastric and umbilical region ;
exascerbations in paroxysm to a violent twisting pain; worse on
lying down and in the morning.

Dulc, colic when the weather changes suddenly from warm to
cold ; griping in the bowels, with nausea, and coldness in the small
of the back ; diarrhoea.

Hyose., colic as if his abdomen would burst, he presses his fists into
his sides; spasmodic cutting, vomiting, belching, hiccoughing, and
screaming.

Ign., periodical abdominal spasms, particularly at night, waking
out of sleep, with stitches running up into the chest and to the sides ;
in sensitive and hysteric women.

I pec, colic of children, with diarrhoea, uneasiness, screaming, and
tossing about.

Kali c, colic, as if the intestinal canal were full of water.
Lycop., bloatedness in consequence of incarcerated flatulence and
constipation, with urging to stool ; a feeling as if the abdomen must
burst; belching without relief; passing flatus downwards relieves;
renal colic, where the pain is felt along the ureters into the bladder,
especially in the right side.

Merc, colic occasioned by the cool evening air, with diarrhoea,
chilliness, and shuddering.

Nux vom., flatulent distention of the abdomen, with pressure up-
wards into the chest, and downwards upon the rectum and bladder ;



COLIC. 301

would like to belcli, but cannot; constant urging to stool without
effect, and frequent desire to make water ; wind colic, hemorrhoidal,
renal, and lead colic.

Opium, when flatulence accumulates in the upper portions of the
bowels, causing a distention of the abdomen, especially in the um-
bilical region, with antiperistaltic motion, belching and vomiting ; the
bowels seem perfectly closed, but there is a constant urging to stool
and to urinate ; the pain is cutting, pressive, and twisting ; painter's
colic.

Platina, painter's colic ; pain in umbilical region, extending through
into the back ; the patient screams, and tries to relieve the pain by
turning in all possible positions.

Plumb., frightful pain, particularly around the umbilicus ; the um-
bilicus drawn in towards the spine ; obstinate constipation.

Podoph., cramps in the bowels, with retraction of the abdominal
muscles, or crampy drawing up of the muscles into lumps and knots ;
lead colic.

Puis., colic worse in the evening and at night; pale face; white
tongue ; no thirst ; wants to uncover ; grayish diarrhoea ; tearful dis-
position.

Rheum, in infants with sour diarrhoea ; the child smells sour all over.

Rhus t., worse at night, and when being quiet; better from moving
about.

Sabad., sensation as if a ball of thread were moving and turning
rapidly through it. " Oh, my bowels ! it runs like a wheel !"

Sepia, boring, burning pain, with great distention and sensitiveness
of the abdomen ; anxiety ; typically recurring towards evening ;
scrofulous persons.

Stann., stitches from both sides through the abdomen and through
the hips; worse from slightest motion or touch, and when lying on
right side ; vomiting of water when smelling any kind of cooking.

Sulphur, spasmodically contractive colic, extending into the chest,
the groin, and the genital organs; from piles; from flatulence; from
eating sweet things ; relieved by sitting bent ; psoric individuals.

Tart, em., violent colic, as if the bowels would be cut to pieces;
violent cutting and labor-like tearing from above downwards, across
the groin through the thighs down to the knees ; nausea; accumula-
tion of water in the mouth ; shifting of flatulence, with rumbling in
the bowels and diarrhoea.

Thuya, hemorrhoidal colic, with very acute and violent pain in the
lower bowels ; much flatus, with or without stool ; feces hard or fluid



302 INTESTINAL CANAL.

and scanty ; when fluid there is a sensation in the rectum, as if boiling
lead were passing through,

Veratr., abdomen swollen and very sensitive ; violent pinching
pains ; no discharge of flatus either up or downwards ; the intestinal
canal seems closed ; nausea ; inability to swallow ; cold perspiration ;
anxiety ; restlessness ; after eating fruit or vegetables.

Zinc, flatulent colic, worse from wine, towards evening, and when
at rest ; loud rolling and rumbling; retraction of the abdomen; hot,
moist flatus passing off without relief; lead colic.

Tuberculosis Sntestinalis, Consumption of the Bowels.

Just as tubercles form in the lungs, so they are apt to be deposited
into the mucous and submucous membrane of the ilium, and especially
into Peyer's and the solitary glands, spreading downwards over the
colon, rarely, however, upwards over the jejunum and duodenum.
Exactly like tubercles in the lungs and other organs, these consist
either of a yellowish, cheesy, or of grayish, half- transparent, so-called
miliary granulations, which, by a gradual dissolving process, form
tubercular ulcers and even perforations of the intestine.

Intestinal tuberculosis is rarely a primary disease, but is generally
part and portion of — 1. Pulmonary consumption, to which it adds the
finishing blow. In some cases, however, the intestinal tuberculosis
seems so to predominate over the pulmonary complaint that this
latter is disguised by the abdominal troubles.

2. In other cases intestinal tuberculosis attends acute miliary tuber-
culosis ; a form of blood-poisoning, which, under the symptoms of
typhus, deposits a great number of fine granules in different organs
and tissues. It cannot be distinguished from typhus ; or, if the depo-
sition within the pia mater causes inflammation there, from a tuber-
cular meningitis.

Lastly, intestinal tuberculosis may be part and portion of tubercular
formations within the peritoneum, the mesenteric glands, and the
retroperitoneal glands, all of which are difficult of diagnosis.

The symptoms are not at all prominent or characteristic, only when
the tubercles commence to dissolve in the last stage, then the ob-
stinate diarrhoea is one of the most prominent symptoms. With it is
associated great loss of strength, night-sweats, oedema, here and there,
and the patients die with all signs of marasmus.

Obstinate diarrhoea, in conjunction with pulmonary tuberculosis,
suggests the following remedies : Ars., Bry., Baryta c, Calc. c, Calc.



CANCER OF THE INTESTINES. 303

phos., Carbo v., China, Ferr., Hepar, Nitr. ac, Phos., (Plumbum,)
Phos. ac, Puis., Sulph.

Cancer of the Intestines

Appears eitber in tbe form of scirrhus or fibrous cancer, or as
medullary cancer, (wbicb is of a softer, marrow-like growth,) or as
alveolar cancer, (which is of a jelly-like nature, but of rare occurrence.)
It originates either within the submucous and mucous coats of the
intestines, or the gut is secondarily affected by its spreading from
neighboring organs, as lymphatic glands, peritoneum, liver, ovaries,
uterus, and so on.

It is found mostly in the rectum ; also in the flexura sigmoidea ; very
rarely in the remaining parts of the colon. The small intestine be-
comes only secondarily affected. As it grows, it causes a swelling or
tumor from the size of an egg to that of a fist ; and by its growth
gives rise to intestinal obstruction. Nevertheless its diagnosis may
in certain cases be one of great difficulty. It may be suggested by
partial intestinal obstruction; rarely by total obstruction; also by the
general symptoms of cancer-cachexia. Or in younger individuals it
may cause intestinal obstruction alone without these general symptoms
of cancer-cachexia. Or it may produce merely the general cancer-
cachexia without any sign of intestinal obstruction ; but in place of
it diarrhoea, colicky pain, flatulency, &c.

The main points of diagnostic importance are these : The presence
of an uneven, potato-like tumor ; the slow but steady development of
intestinal obstruction ; the peculiar dry and ash-colored skin ; the fast
wasting away in strength and flesh ; and the age of the patient, as
cancer very rarely appears before the fortieth year of age.

Cancer of the eectum is the most frequent in occurrence. At
the beginning of its development, when it causes a pressure upon and
a consecutive swelling of the hemorrhoidal veins, with occasional
bloody discharges, and pain from the os sacrum down into the thighs,
it is mostly confounded with hemorrhoides. Later, however, the
obstruction of the rectum becomes more apparent by the form of the
discharged feces, which appear pressed, flattened, angular, or pass off'
in small hard nuts like sheep- dung. Manual examination reveals
now a knotted tumor, which encircles the gut like a ring. In its still
further advanced stage this tumor suppurates, and the bursting of
blood-vessels may occasion profuse hemorrhages. We sometimes ob-
serve in combination with it indurated inguinal glands : and I have



SO-i INTESTINAL CANAL.

seen a case where hard scirrhous tumors were discriminated even
through the glutseus muscles.

Its prognosis is, like that of all cancers, very discouraging.

By means of the following remedies we may succeed in alleviating
much suffering :

Apis., Ars., Bell., Carbo veg., Clem., Cann., Graph., Kreos., Hepar,
Lach., Phos., Phos. ac, Ehus t,. Sepia, Silic, Sulph., Thuya.

Intestinal Worms, Entozoes, Helminthes.

Worms play, in the practice of common doctors and old women,
about as important a part as dyspepsia and liver complaint, the un-
holy trias, wherein consists the practice of a genuine know-nothing in
medical science. The symptoms which have been heretofore attributed
to worms are of so variable a natiire that almost any intestinal irrita-
tion and something else too, might be attributed to worms, and yet
there is only one sure and unmistakable sign of their presence in the
intestines, viz., their occasional passing off with alvine discharges.
All other symptoms may be produced just as well by the most hetero-
geneous affections of the human organism. But symptoms they do
produce, that is true, and these symptoms vary according to the kind
of worms which infest the intestines. There have been found and
described five different species, but only three of them are of practical
importance.

1. OxTUEis VERMICULARIS, THREAD or seat-worm^ mostly called
ascaris. This parasite is from two to five lines in length, white,
slender, very active. Its head is club-shaped, its tail curved in males
and straight in females. The latter are by far the most numerous.
They inhabit the rectum principally, and are found more frequently in
children than in grown people.

How these little tormentors come into the human intestines has not
been ascertained yet. Doubtless they do not originate there ; for
there have not yet been found any eggs or intermediate phases of the
worm. Only this seems to be the positive fact, that they are found
more in such children and persons as live principally on farinaceous
food.

Symptoms. — By their constant active motions they cause irritation
and tickling in the anus, which obliges the child to scratch and rub
these parts ; in consequence of which we frequently observe a catarrhal
inflammation of the mucous membrane of the anus — even blennor-



WORMS. 805

rlicea — from it ; also swelling of tlie hemorrlioidal veins, witli tenes-
mus. Their inclination to travel in the case of females into the vagina,
and in that of males under the prepuce, causes, in these parts, the same
intolerable itching and catarrhal inflammations, and may give rise
to the bad habit of masturbation.

Cleanliness, injections of cold water, are generally sufficient to re-
move this irritation by removing the parasites themselves. The
nightly restlessness and intolerable itching which sometimes throws
children even into fever, relieves Aconit.

2. The ascaris lumbricoides, round worm^ is of a cylindrical form,
pointed at both ends, six to twelve inches in length, and of the thick-
ness of a goose-quill, thus resembling somewhat the common earth-
worm. Its body, however, is half transparent and of a whitish,
yellowish, or even brownish hue. There are males and females.
The females are more numerous and larger than the males.

This worm inhabits the small intestine, but sometimes it ascends
into the stomach, winding its way up into the oesophagus and being
discharged through the mouth. In the Surgical Museum, at Wash-
ington, I saw a preparation of a larynx, into which a round worm
had entered, causing death by suffocation. It may even find its way
into the ductus choledochus, or creep into the vermicular process,
causing dangerous inflammatory symptoms in these parts.

Symptoms. — They are found sometimes in large numbers without
causing any disturbance ; but they do sometimes give rise to abdom-
inal gripings, increased secretion of slime ^ diarrhoea, vomiting, irregular
appetite; or, they cause reflex or sympathetic symptoms, as, itching
of the nose, anus, genitals; enlargement of the pupils, squinting, in-
creased fioio of saliva, restless sleep), ivith frequent starting and grating
of teeth.

Symptoms like the following : cachectic countenance ; blue rings
around the eyes; enlarged abdomen, fever, irritation of the brain,
fits, convulsions, &c., which have been ascribed to worms, are rather
doubtful. In such cases a careful examination will, no doubt, lead to
other exciting causes.

Therapeutic Mints. — In the first place there is no need of dis-
turbing the system with so-called vermifuges. Worms won't eat up
a child, nor kill anybody, except in those very rare cases where "one
of the critters goes into a wrong passage."

Secondly, those symptoms of irritation are easily subdued if we

20



806 INTESTINAL CANAL.

choose homoeopatliically between Cina, Spigelia, Sulphur, Bell., and
other remedies.

Lastly, as it is most probable that, according to the latest researches,
these worms do not propagate in the intestine, but are brought there
by means of food, a change of diet might be the best means to pre-
vent their accumulation;

3. T^NIA SOLIUM or common tape-roorm, inhabits the small intestines.
It consists — 1. Of a head as large as a pin's head ; upon its front part
we observe four sucking cups, in the middle of each of which is a
nozzle or snout, which again is encircled by a double row of hooks.

2. Its nech joins the head, and is slender, flat, half an inch long, or
more ; but exhibits no segmentation.

3. Its body consists of a long row of segments, each of which has a
rectangular shape, and contains both a male and female organ, the ori-
fices of which are joined at the apex of a lateral papilla. These
papillse are so arranged that each following segment has it on the
opposite side, so that they run along alternately from side to side.
The size of the segments increases gradually toward the caudal ex-
tremity, growing broader and broader ; for the parasite is nourished
and grows from its head, the newly-created segments pushing those
already formed before them, so that the caudal extremity is the oldest
portion of the animal, and its segments alone contain ripe eggs. There
may be upwards of eight hundred segments, and the worm may meas-
ure above ten feet in length. The oldest segments fall off' from time
to time, and are discharged ; if they happen to come into a suitable
organism, — for example into that of a pig, — their eggs develop them-
selves there into the cysticercus cellulosa of the pig^ (finne.) This, by
transplantation into the stomach of man, becomes a tape-worm again.
It happens rarely that the intestines of a man harbor more than one
of these unwelcome guests at a time, but there are cases on record
where two, five, or more, have come away from one individual at one
time. They are generally found in those regions where people are
accustomed to eat raw or not well-cooked pork.

There is still another kind of tape- worm —

4. The bothriocephalus latus or t^nia lata, which, instead of
four mouths, has only a pair of fissures on its head ; whilst its sexual
organs lie in the centre of each segment. Its neck is scarcely dis-
tinguishable ; and the segments of its body are broader than they are
long.



WORMS. 807

This kind is found only in Russia, Poland and tlie eastern part of
Prussia. All other parts of this globe are inhabited by the common
tape-worm. Switzerland only is said (Meyer, Avens) to produce both
species.

Symptoms. — Some individuals experience not the slightest incon-
venience from it. Others complain greatly of pain in the stomach,
nausea, vomiting, ravenous hunger, even unto fainting. The abdo-
men is sometimes bloated and sometimes contracted. There exists in
some cases diarrhoea, in others constipation.

Among the sympathetic symptoms may be mentioned, itching of
the nose ; headache ; dizziness ; getting dark before the eyes ; noises
in the ears; palpitation of the heart, &c. ; all which symptoms have
no diagnostic value, unless the corpus delicti itself be found.

Chorea, epilepsy and the like, I should not like to set down as effects
of tape-worm. This latter has been removed and the other has con-
tinued.

All the above-mentioned symptoms caused by worms show this
peculiarity, that they are, in a majority of cases, ameliorated by certain
kinds of nourishment, such as milk, eggs, mild soups, and meat not
spiced ; and that they are aggravated or hrought on by sour things,
especially cucumbers in vinegar and pepper, herring, horseradish,
strawberries, cranberries, carrots, and the Tike. After the eating of
these latter things, some segments are generally discharged, and thus
the diagnosis in a given case may be settled by way of experiment.

Therapeutic Mints, — If no oftence is given, why should we
use the cudgel ? A number of those above-mentioned symptoms may
be relieved by selecting the corresponding remedy, which may even
cause the parasite to leave. But in some cases persons have made
up their minds to get rid of the " critter," no matter what it costs.
As the safest and most expeditious of all the tape- worm remedies,
Baehr has recommended —

Kousso, or the flowers of Brayera anthelmintica, 2-3 drachms put
into a tumblerful of water well stirred, so that none of the flowers
swim on the top. This done in the evening, let it stand over night.
Administer a cup of coffee before taking it in the morning, to prevent
nausea. Then one-half of it is taken, and the other half, half an hour
later. If inclination to vomit should set in, it is best subdued by
lemon juice.

Within one hour and a half to four hours the parasite is dis-
charged.



Online LibraryCharles Gottleib RaueSpecial pathology and diagnostics : with therapeutic hints → online text (page 31 of 65)