Prognosis of membranous colitis not especially favorable, since there is little prospect of ultimate cure unless a radical change can be effected in the circum stances and surroundings of the patient. O. D. Doane (Med. Sentinel, Sept., '95).
must be di rected to the underlying state, although the condition of the digestive tract must not be ignored. Nervines, tonics, intes tinal antiseptics, and supporting meas ures generally are the agents indicated. Asafetida, sumbul, valerian, iron, strychnine, hydrogen dioxide, creasote, guaiacol, singly or in varying combina tion, are sometimes useful. The best re sults are to be expected from rest and a milk diet, with massage and electricity, and later forced feeding and a gradual return to the ordinary mode of life.
In the treatment of membranous coli tis rest in bed is essential, with ab dominal friction to soothe the pains, using a soothing liniment or camphor ated oil to which laudanum has been added. If the pain is very acute, opiates may be given in small doses, either as a potion or an enema. Letcheff recom mended the use of copious irrigations with hot solutions of nitrate of silver in the proportion of 1 to 2000, or even 1 to 1000. Touvenaint (Revue Inter. de Mild. et de Chic., July 25, '93).
In membranous enteritis or mucous colic abundant nourishment is of the greatest value. An ample mixed diet, containing plenty of vegetables, should be given. In severe attacks, rest in bed, warm poultices to the abdomen, a cleans ing enema of warm water, and afterward the administration of codeine or opium, with or without belladonna, and light food, is the best treatment. In the inter vals free from pain the treatment con sists in the methodical use of enemata of oil, as suggested by Kussmaul and Flei mer. One-half to 1 pint of oil at blood temperature is injected into the bowel at night. The patient should try and retain the enema all night. The oil should be injected every night for three weeks; every other night for three weeks; twice a week for four weeks; finally a weekly injection for five or six months. In ad dition, patients must accustom them selves to a regular morning evacuation.
The results achieved by this method of treatment are very satisfactory. Max Einhorn (Med. Record, Jan. 28, '99).
As most of the food taken during the day reaches the large intestine by the following morning, remedies to heal ulcers of the colon should be -given before the patient is allowed to have any nourishment, the breakfast being post poned for a few hours. By this means, and an early morning injection, cases re bellious to other methods have been cured. Richter (Then Monats., Mar., '99).
The first indication for treatment is to relieve the colonic symptoms proper. Nothing is so soothing to the tenesmus and the general abdominal distress as irrigation of the colon with decinormal saline solution at a temperature of 110° F. This irrigating fluid should contain 5 drops of oil of peppermint to the pint of water. The irrigation should be given with the Kemp rectal irrigator, and sev eral gallons of the saline solution should be used. This irrigation may be used as often as once in twelve hours. Unfortu nately such treatment is not curative. In small or alterative doses of castor oil the physician possesses a remedy which is believed to be distinctly cura tive in this affection. Castor-oil should be given in an emulsion, each tablespoon ful of which contains drachm of the oil. It should be given half an hour be fore, or more than one hour after, meals, and should he continued for months at a time. Another useful remedy is nitrate of silver given in doses of grain of the silver salt, combined with 9 minims of turpentine, in capsules, three times daily. After a course of this medication for six weeks, sulphate of copper should be sub stituted for the silver salt, and should be given in doses of 'A grain. Abdominal massage and out-door exercise are useful adjuncts. These patients should be told simply to exclude beans, corn, spinach, and the woody vegetables from the diet ary. W. H. Thomson (Med. Record, Mar 10, 1900).
Tumors of the Cmcum, the Colon, and the Duodenum.