Licence: Public Domain Mark
Credit: Lectures on the theory and practice of physic (Volume 1). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![stance of the absence of organic change with the singular fact which I mentioned in my last lecture, that the comatose symptoms of this affection may be 'treated with stimulants and opiates. Where we have coma with congestion of the brain, opium has the effect of in- creasing the symptoms ; here it was found to have a contrary effect. So that our experience and the results of pathological anatomy, as far as they go, appear to square exactly. We see, then, that painters' colic is not inflammation of the intestines, or of the brain, or of the spinal cord, and this information, though of a negative character, possesses considerable value in a practical point of view. I do not know any cases of what have been termed neuroses, in which the bearings of pathological research on practice are so extensive and so satisfactory.* Treatment. — It is a fortunate circumstance that this disease is sel- dom fatal, and it is some consolation to think that, although the patient's sufferings are dreadful and often protracted, there is little danger of life, and that the complaint is almost always amenable to judicious treatment.! I have been for some years in the habit of treating it in a routine way, and can speak from experience of its success— of course this treatment is to be modified by circumstances. Suppose a patient applied to you with violent pain about the navel, a hard and retracted state of the abdomen, obstinate costiveness, and the other symptoms which characterise an attack of painters' colic; the first thing I would advise you to do is to prescribe a full opiate. Many persons would object to this, and say that there is constipa- tion enough already, and that opening the bowels would be much more likely to give relief. But opium does not here add to the constipation : indeed, so far from doing this, it sometimes acts as a laxative. At all events, it is a remedy which is perfectly unobjec- tionable. Give, then, in the first place, a full opiate ; it will have the effect of relieving the patient's sufferings, and will enable you to gain time for the employment of other means. The next thing is to place the patient in a hip bath, and keep him in it as long as possible. Do not neglect this, for I know of nothing that gives more decided relief. I have often seen cases where the patient was quite easy while he remained in the bath, but experienced a return of the pain as soon as he left it. If you have no means of procur- ing a bath in this way, the next best thing is to have recourse to * [The impeded and perverted function of the nervous and mus- cular svstems in lead poisoning, is now attributed to the presence of the metallic preparation itself in the organs and tissues, consequent on its absorption. The palsy, as of the hand, in urist-drop, is owing, Dr. Budd thinks, to the local action of lead in the poisoned parts, and not to any change in the central organs of the nervous system. — B.] t [Out of the entire number of cases of lead colic, 4809 observed and recorded by M. Tanquerel and others, 111, or 1 in 43, terminated fatally. It would be more correct to say, that the deaths here were from lead poisoning, as, with one exception, the fatal result is said to be either owing to cerebral affection, to paralysis of the respira- tory muscles, or to some accidental complication with disease foreign to those from lead. — B.]](https://iiif.wellcomecollection.org/image/b21156955_0356.jp2/full/800%2C/0/default.jpg)
