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CHAPTER V. CURE OF ILEUS.

IN Ileus it is pain that kills, along with inflammation of the bowels, or straining and swelling. A most acute and most disgusting form of death! For others, when in a hopeless state of illness, fear nothing except their impending death; but those in ileus, from excess of pain earnestly desire death. The physician, therefore, must neither be inferior to the affection, nor more dilatory; but, if he find inflammation to be the cause, open a vein at the elbow by a large orifice, so that blood, which is the pabulum of the inflammation, may flow copiously; and it may be carried the length of deliquium animi, for this is either the commencement of an escape from pain, or of a torpor ending in insensibility. For in ileus a breathing-time for a short space, even from loss of sensibility, will prove an interval from pain; since, also, to persons enduring these pains, to die is happiness, but to impart it is not permitted to the respectable physician; but at times it is permitted, when

he foresees that present symptoms cannot be escaped from, to lull the patient asleep with narcotics and anæsthetics.

But if the ileus arise without inflammation, from corruption of the food or intense cold, we are to abstain from bleeding, but at the same time to do all the other things, and procure vomiting frequently by water, and drinking plenty of oil; then, again, we are to procure vomiting, and produce the expulsion of the flatus downwards, by stimulant medicines. Such a stimulant is the juice of sow-bread, and natron, or salts. Cumin and rue are carminatives. Wherefore we must rub in together all these things with turpentine resin, and foment with sponges; or we must inject with these things and oil, honey, hyssop, and the decoction of the fleshy parts of the wild cucumber. And if feculent matter be evacuated, we are again to inject hot oil with rue; for, if this remain inwardly, it proves a grateful fomentation to the bowels: and apply to the suffering parts lotions composed of oil which has been strongly boiled with rue and dill. And the fomentation is also to be applied, either by means of earthen or brazen vessels, or with millet and roasted salts. In addition to the ordinary cataplasms, one may be made of the flour of darnel and cumin, and the hair of hyssop and of marjoram. Cupping, without the abstraction of blood, indeed, but frequently applied, sometimes to one place, and sometimes to another--to the epigastric region, and to the loins as far as the groins, and behind to the ischiatic region as far as the kidneys and spine; for it is expedient to produce revulsion of the pain by all means. They should also get whetters (propomata1) of the decoction of cumin, or of rue, and of sison;2 or along with these some of the anodyne medicines. Of these there are very

many of tried efficacy. The medicine from vipers is also a good one, when drunk to a larger amount than usual. But if neither the pain remit, nor the flatulence nor fæces pass, we must necessarily give of the purgative hiera; for either the medicine is rejected with phlegm and bile, or it passes downwards, bringing off flatus, scybala, phlegm, and bile, which occasion the intensity of the evil. Laxative food: soups of hens, of shell-fish; the juice of ptisan boiled with much oil poured in at first before the boiling; boil along with it cumin, natron, leek with its hair. Or the cure is to be made with some laxative soup: snails much boiled, and their gravy, or that of limpet. Water is to be taken for drink, if there be fever, boiled with asarabacca, or nard, or cachry. For these things dispel flatus, are diuretic, and promote free breathing. But if he be free from pain, wine also is beneficial for the heat of the intestines, and for the restoration of the strength; and likewise the decoction of fennel-root, in a draught, and maiden-hair and cinnamon.

But if the inflammation turn to an abscess, it is better to contribute thereto by using the medicine for abscesses. These have been described under chronic diseases, where the treatment of cholics is described.

1 See Bekker's Charicles, p. 248; and Paulus Ægineta, t. iii. p. 546.

2 The Sison amomum, Stone parsley, or German amomum. See Dioscorid. M. M. iii. 57; Galen. de Simpl.vii.; and Paulus Ægineta, t. iii. p. 339.

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