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
Catalogue details

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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    4. Obturation by Fecal Masses. In the chapter on Constipation I have already described the accumulation and condensation of fecal masses in the colon which occur in habitual obstipation. This condition is more frequently the result of defective innervation of the intestine, and in rare instances of congenital or acquired debility of the muscular peris- talsis. The formation of fecal concretions or coproliths, under such conditions, occurs preferably in such localities of the colon in which the progress of the feces is to a certain extent impeded by natural difficulties of the lumen. We therefore find them preferably in the cecum, the flexures, and the sigmoid colon. The longer they remain, the harder they become. At first they are simply con- densed stagnating masses, which do not obstruct the bowel entirely; gradually they become hardened by the loss of water by absorption, and larger by the further deposition of solid material. In such cases the clinical picture of a slowly progressing stenosis may develop, occasionally becoming suddenly aggravated to an absolute occlu- sion. If the loops that are made gravid by this accumulation are dislocated, they give rise to kinking or the development of a volvu- lus of the sigmoid flexure. The lethargy of the colon may be still more aggravated by the distention or the weight of the stagnating material and the gases formed therefrom. Paralysis of the muscu- lature, including all the symptoms of intestinal occlusion, may follow. If a stenosis has previously existed,—for instance, one depending on an ulcer or a carcinoma,—a fecal concretion may become lodged in front of it and render it an absolute obstruction. Symptomatology.—The symptoms of coproliths will be those of chronic entcrostenosis or of intestinal occlusion, with the features that are characteristic of these conditions. When the fecal accu- mulation is in the sigmoid or rectum, tenesmus will be a prominent symptom, which will not be present if the mass is in the ascending or transverse colon. Diagnosis.—The diagnosis is not always easy, and the fecal tumor has been mistaken for neoplasms, abscess, and floating kid- ney. The statistics of H. Illoway, in his scholarly monogiaph on “Constipation,” give numerous cases of this sort. There are cases of this kind in which there may be an enormous accumulation of hard and dry feces in the rectum, and still a spurious kind of dial-