Medical and physiological problems : being chiefly researches for correct principles of treatment in disputed points of medical practice. Pt. first ... / by William Griffin and by Daniel Griffin.

  • Griffin, William, 1794-1848.
Date:
1839
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Licence: Public Domain Mark

Credit: Medical and physiological problems : being chiefly researches for correct principles of treatment in disputed points of medical practice. Pt. first ... / by William Griffin and by Daniel Griffin. 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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    Let US contrast these with other opinions of the very highest character. Dr. Abercrombie says, “ we have seen the bowels obstinately obstructed, and we have seen them spontaneously open or easily regulated, and in both cases the disease has run its course with equal rapidity to a fatal termination. We have found no reason to believe that the retention of faeces was in itself injurious in one case, or the free evacuation of them beneficial in the other ; on the contrary, we have had evident reason to be- lieve, that in several cases in which the inflammation appeared to be subdued, the action of a purgative was immediately followed by a renewal of the symptoms. Along with these considerations, we must keep in mind the fact, that in the ordinary cases of enteritis, the action of purgatives is in general entirely fruitless ; they are usually vomitted as often as they are given, and consequently can only prove additional sources of irritation. 1 know that much difference of opinion exists upon this subject among practical men ; but upon the grounds now referred to, I confess my own impression distinctly to be, that the use of purgatives makes no part of the early treatment of enteritis ; on the contrary, they are rather likely to be hurtful until the inflammation has been sub- dued. When we have reason to believe this has taken place, the mildest medicines or injections will often be found to have the effect, after the most active purgatives had previously been given in vain. In the general treatment of enteritis indeed it is de- sirable to keep the bowels if possible free from distention; but this object may, I think, be usually obtained by mild injections, or by the tobacco injection.” Dr. Gregory, of London, and other physicians of equal respectability, entertain similar views with Dr. Abercrombie in the treatment of this disease. Broussais limits the use of purgatives to the close of the acute stage, and Armstrong, of whose practice I shall have to speak again pre- sently, leaves them altogether out of sight, or mentions them only as requisite when the inflammation is over. It remains for us amidst these conflicting opinions to inquire anxiously on which we are to rely in practice. The following interesting case may assist us in determining the question. Case I.—A lady, aged thirty-two, while engaged with an evening party, on the 1st of November, was affected with pain in the lower part of the back, and great weariness. She took three glasses of port wine with the hope of relieving it, but they did her no service ; she became feverish in the night, and in the