On intestinal concretions / by Patrick Heron Watson.

  • Patrick Watson
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: On intestinal concretions / by Patrick Heron Watson. Source: Wellcome Collection.

    11/12 (page 11)
    Dr Maclagan, in speaking of the microscopic appearances of these two specimens he had an opportunity of examining, says . On submitting portions of these concretions to examination by the micro¬ scope, the hairy matter of the oat was at once recognised as forming by far the largest proportion of the constituents of the concretions. When a portion of the mass, scraped down, was viewed under a magnifying power of 50 diameters, it presented the appearance o numerous hairs mixed with broken fragments of other matters, some of which were opaque, others being more or less translucent-like portions of vegetable membrane. Tim hairs varied m size but were on an average about l-16th of an inch long, and l-1000th ol an inch broad at the centre. When viewed with a magnifying power of 300 diameters, their tubular structure became at once apparent. The cavity contained what looked like dried cellular tissue, lhey were closed at the points, but readily admitted water by imbibition, which could be seen moving along the tube. Dr A/V ollaston thinks them to be pointed at both ends. This is not strictly the case. The apex is pointed, and they become thicker towards the centie, but the other extremity I found to be invariably broken off and open, and though they tapered towards the end, they were never found to be pointed.” . ^ The diagnosis of this case, so far as it came under my observa- tion, was unattended by any difficulty. At an earlier period also, when the lump was recognised in the right hypochondriac region, and shifted thence to the left, any one acquainted with Professor Monro’s observations should have found no difficulty in determining the nature of the affection. The early history of enteric concretions, consisting simply of a long period of digestive disturbance and uneasiness, may readily elude the diagnostic skill of the most pains¬ taking and careful practitioner. If the nature of such a case were satisfactorily determined, beyond avoiding the cause of the formation in ill-ground and worse sifted oatmeal, the use of oleaginous sub¬ stances which seem to interfere with the felting process, and the use of simple laxatives, there seems no room for interference. JNor while traversing the small intestines, if recognisable at that period, is there anything which can well be attempted, unless indeed gastro- tomy were employed in -a hopeless case of obstruction produced by such a cause. After the concretion has reached the large intestine, how¬ ever, there seems no reason why the distending enemata recom¬ mended by M. Jules Cloquet1 should not be resorted to as a means of facilitating their onward progress towards the rectum. I Ins process he well describes under the name of “ Dilatation gradudh de Vintestin,” consists in separating the walls of the intestine gradually by an increasingly large quantity of liquid. _ or 1S 1, recommends that a conical tube should be m 10 nee m rectum, so as to prevent the escape of fluid from the anus, wh the forcible injection of fluid is employed for the purpose of distend- 1 Memoir sur les Concretions Intestinales.