The principles of treatment and their applications in practical medicine / by J. Mitchell Bruce.

  • John Mitchell Bruce
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: The principles of treatment and their applications in practical medicine / by J. Mitchell Bruce. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    is not always easy or indeed possible to deal with the causes when they have been discovered. Errors of diet and ca^ele^~ habits may be corrected; but certain defects and diseases of the bowels, even of a functional kind, are beyond remedy. Structural disease involving the bowel, mechanically and otherwise a cause of fiecal retention, demands direct attention. The constipation produced by this gravest of all causes usually receives exaggerated treatment, for instance in intestinal ob- struction : it is of insignificant concern compared with other effects of the disease. In some cases belonging to this group, however, removal of the cause is a simple affair, such as replace- ment of a retroverted gravid uterus or the clearance of a faical mass impacted in the rectum. Atony of the muscular coat of the intestine is beheved to be a common intrinsic cause of constipation. The muscuLu' weakness is in many instances more correctly torpidity or nervo-muscular lethargy or languor begotten of neglect, that i - of abuse of rest of the bowel by wilful inattention to natural promptings and sedentary life. This type of constipatio]) is most common in women. The indication for treatment here is to exercise the bowel, with a view to train or educate it to discharge its functions regularly. The object and the test of success is to secure every day a single, punctual, sufficient action, which at the same time shall not interfere with the appearance of an equally sufficient evacuation on the following morning, but on the contrary favour it. This end is accomplished by adopting a rational method of stimulation of the intestinal wall, just as well-planned stomachic measures are so successful in chronic dyspepsia. In the words of Andrew Clark we have first to insure on the part of the patient regular solicitation, patience, and contentment with moderate result. ^ Torpidity of the body as a whole must be met by regular exercise in the fresh air. As a rule the diet has to be temporarily modified so as to include foods that are naturally laxative and to exclude foods that are naturally astringent. We shall return to this subject presently. Eeforms in these different and diverse directions may suffice to restore the interrupted or irregular action of the 1 Sir Andrew Clark, Brit. Med. Journ., London, 1887, vol. ii. 1106.