Diseases of the intestines, their special pathology, diagnosis, and treatment : with sections on anatomy and physiology, microscopic and chemic examination of the intestinal contents, secretions, feces and urine intestinal bacteria and parasites; surgery of the intestines; dietetics, diseases of the rectum, etc / by John C. Hemmeter.

  • Hemmeter, John C. (John Conrad), 1863-1931
Date:
1902
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Licence: In copyright

Credit: Diseases of the intestines, their special pathology, diagnosis, and treatment : with sections on anatomy and physiology, microscopic and chemic examination of the intestinal contents, secretions, feces and urine intestinal bacteria and parasites; surgery of the intestines; dietetics, diseases of the rectum, etc / by John C. Hemmeter. Source: Wellcome Collection.

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    lS4 ACUTE OBTURATION BY GALL-STONES, vomiting is moderate, and usually decreases after a time. It rarely becomes feculent, and sometimes is altogether wanting. After the resolution of the volvulus, blood is often found in the diarrheic evacuations. Whether it may be found in the stools before this is not evident from any clinical reports. Tenesmus frequently sets in quite early. The amount of indican in the urine does not in- crease for the first few days. It is impossible to pour more than one liter of water into the rectum, and also to inflate the descending colon with air. Loop knot formations between the sigmoid flexure and the ileum cause the same symptoms as the axial twists. It is said, however, that in this case bloody diarrheas are much more frequent than in axial twists. Intussusception.—The diagnosis of acute and chronic intussus- ception has been thoroughly discussed in a separate chapter. Acute Intestinal Obturations.—(a) Obturation Caused by Gall- stones.—Obturation due to gall-stones is not at all rare. It usually occurs in elderly persons, principally women. It is sometimes ob- served as a direct consequence of biliary colic; at other times this colic has preceded it a long time. Occasionally a gall-stone, or a fragment of one, is found in the last stool previous to the obtura- tion. An obturation by means of gall-stones may occur, however, without being preceded by the symptoms of cholelithiasis. The only way in which large stones can get into the colon or the small intestine is by the formation of a fistula between the gall-bladder and the intestine, or the gall-duct and the intestine. The formation of gall-bladder fistulas causes either the symptoms of a violent cholelithiasis or cholecystitis, but it also may remain completely latent. If, however, a stone is present in the common gall-duct, and a fistula of the latter is formed, the symptoms of cholelithiasis are hardly ever absent. If the gall-stone ulcerates directly through into the large intestine, it usually passes off without causing any disease symptoms, even if it is of considerable size. It may even remain for a considerable length of time in the large intestine with- out causing any complaints. But if, in its downward passage, it sticks fast in the rectum, it may become an obstruction to defecation, and then must be removed artificially. If stones of any consider- able size get into the small intestine, they stick fast in it; the most frequent location of blocking beingimmediately in front of the ileocecal