CHAPTER VI. ON ILEUS
AN inflammation takes place in the intestines, creating a
deadly pain, for many die of intense tormina; but there is
also formed a cold dull flatus (
pneuma), which cannot readily
pass either upwards or downwards, but remains, for the most
part rolled up in the small convolutions of the upper intestines,
and hence the disease has got the appellation of
Ileus (
or
Volvulus). But if in addition to the tormina, there be compression
and softening of the intestines, and the abdomen
protrude greatly, it is called
Chordapsus, from the Greek
word
ἕψησις, which signifies softening, and
χορδὴ, which is
a name for the intestines; and hence the Mesentery, which
contains all the nerves, vessels, and membranes that support
the intestines, was called
ἐπιχορδὶς by the ancients.
1
The cause of Ileus is a continued corruption of much
multifarious and unaccustomed food, and repeated acts of indigestion,
especially of articles which are apt to excite Ileus,
as the ink of the cuttle-fish. And the same effects may be
expected from a blow, or cold, or the drinking of cold water
largely and greedily in a state of sweating; and in those cases,
in which the gut has descended into the scrotum with fæces,
and has not been replaced into the belly, or has been restored
to its place with violence, in such cases it is customary for the
lower intestines to get inflamed.
2 This affection is customary
with children, who are subject to indigestion, and they
more readily escape from the mischief, owing to their habits
and the humidity of their intestines, for they are loose. Old
persons do not readily suffer from the complaint, but rarely
recover. The season of summer engenders the disease rather
than that of spring; autumn, than winter; but the summer
more than both.
Many therefore die speedily of these tormina. But in
other cases pus is formed; and then again, the intestine
having become black and putrified, has separated, and thus
the patients have died. In these cases, provided the Ileus is
mild, there is a twisting pain, copious humours in the stomach,
loss of tone, languor, vacant eructations bringing no relief,
borborygmi in the bowels, the flatus passing down to the anus,
but not making its escape.
But if the attack of Ileus acquire intensity, there is a determination
upwards of everything, flatus, phlegm, and bile;
for they vomit all these; they are pale, cold over the whole
body; much pain; respiration bad, they are affected with
thirst.
If they are about to die, there is cold sweat, dysuria, anus
constricted, so that you could not pass a slender metal plate by
it;
3 vomiting of fæces; the
patients are speechless; pulse, at last
rare and small, but before death very small, very dense, and
failing. These symptoms attend the disease in the small
intestines.
But the same affections occur also in the colon, and the
symptoms are similar, as also the issue; some of these escape
if pus form in the colon, the reason of which is the fleshy
thickness of this intestine. The pain is slender and sharp
in the small intestines, but broad and heavy in the colon;
the pain also sometimes darts up to the ribs, when the disease
puts on the appearance of pleurisy; and these, moreover, are
affected with fever; but sometimes it extends to the false
ribs, on this side or on that, so that the pain appears to be
seated in the liver and spleen; again it affects the loins, for
the colon has many convolutions in all directions; but in
other cases it fixes on the sacrum, the thighs, and the cremasters
of the testicles. But in colic affections, they have
rather retchings; and what is vomited is then bilious and
oily. And the danger therefrom is so much the less, as the
colon is more fleshy, and thicker than the small intestines,
and consequently more tolerant of injury.