It depends, like other forms of mu cous-membrane disturbance, upon the action of irritants, either generated within the body, such as the products of fermentation or other toxic substances resulting from some inadequacy of func tion, or introduced from without, such as indigestible or decomposing food, or an excess of food.
Effect of temperature on intestinal fer mentation studied, using the ethers in the urine as an indication of the extent of the process. Individual predisposition was found to exert a decided influence. A draught of air over the abdomen of a sleeper often increased fermentation, al though some subjects were unaffected. Local chilling with ice always produced an increase of fermentation. L. Cantu (Centralblatt f. Bakter. and Parasitenk., Aug. 15, '94).
Excessive intestinal fermentation or putrefaction, either from excessive for mation of moderately-toxic bodies or through the temporary appearance of bodies of greater toxicity, may cause various forms of toxemia.
Many minor ailments arc connected either with excessive intestinal fermen tation or perhaps with modified intes tinal fermentation, such as diarrhma with offensive and perhaps fermented stools, and flatulence with abdominal pain and distension. Also anaemia, mal nutrition, vomiting, headaches, the so called "biliousness," and many nervous manifestations. R. N. Chittenden (Die tetic and Hyg. Gaz., June, '96).
There are two forms of intestinal fer mentation produced by micro-organisms, the one of the carbohydrates, the other of the proteids present in the gut, and they are mutually antagonistic to one another. The fermentation of carbo hydrates leads to the evolution of gases, and to the formation of organic acids. The gases cause discomfort and the acids interfere with pancreatic digestion, but the products formed are not very poison ous nor irritating. On the other hand, the fermentation of proteid bodies caused by bacteria results in the formation of gases of more varied character, though in sonic cases no gas may be evolved, and in the production of many deriva tives of a poisonous and dangerous action. The faeces are most offensive. In acute cases there are febrile symp toms; in chronic, depression and nerv ous affections. Bartley (Brooklyn Med. Jour., Aug., '96).
In mucous enteritis the characteristic discharges are simulated only by those of tubercular enteritis. P. F. Barbour
(Amer. Pract. and News, xxx, p. 11, 1900).
It may be acute or chronic and of vary ing degrees of severity.
Prognosis.—The prognosis varies with the character of the causative agent and the general condition of the patient.
Treatment.—The treatment is best conducted with the patient in bed. Under such conditions recovery may fol low mere restriction of the diet. This may include milk, strained broths and soups, beef-tea, beef-juice, farinacea, and possibly soft-boiled eggs. In aggra vated eases it may be well to withhold all food for a time and give only albumin water or barley-water.
When the condition is attributable to improper food or to the presence of irri tating intestinal contents an initial dose of a teaspoonful each of castor-oil and camphorated tincture of opium may be given.
Enterocolitis contra-indicates the use of drastic purgatives. Small doses of senna with hydrastis or liamamelis give good results, if there are bloody stools. Besides hygienic measures (massage, Swedish gymnastics) and regulation of diet, laxatives and enemata advised. One day a large enema may be given, and the next day 3 teaspoonfuls of castor-oil. The large injections must be given gently, the quantity may be 1 litre, litres, to 2 litres at the most. Solutions of borax or sodium chloride advised, but water containing boric acid or naphthol, which are irritants, con demned. When there are dysenteric stools the use of nitrate of silver in 1 to 3000 or 4000 advised. The diet must be free from irritating or easily-ferment able foods. M. Mathieu (Le Progres Mc-d., June 12, '07).
Opium in some form, or morphine or codeine, may be required when the bowel-movements are unduly frequent and attended with distress or pain. The anodyne may be administered by the mouth or by the bowel in the form of an enema of starch-water with tincture of opium. In many cases irrigation of the bowel, from three to five times a day with from 1 to 3 quarts of fluid, serves a useful purpose. Simple warm water may be used or boric acid (5 grains to 1 ounce) or thymol grain to 1 ounce) or silver nitrate grain to 1 ounce) or mercuric chlorid (1 to 10,000) may be added in suitable proportion, care being taken that those solutions containing substances capable of toxic activity be not retained.