The first examination should be directed to the rectum
The first examination should be directed to the rectum
In such cases, the first examination should be directed to the rectum; the finger, moistened or oiled, ought to be inserted, and the intestine explored as thoroughly as possible. This operation is, however, not of further use than to confirm the opinion of the practitioner; and I, knowing the cause, therefore dispense with it. A copious enema should be immediately exhibited. One containing turpentine is the most effective; but, on account of its activity, it is only safe in the beginning of the attack. A warm bath is of service, but it takes up time which may be better employed, and does not do sufficient good to recompense for the delay. A full dose of sulphuric ether and laudanum should be given to allay the pain, and it may with this intention be repeated every ten or twenty minutes. If, from the enema, nothing follows, the finger should then certainly be introduced, and perhaps a compact mass may be felt firmly grasped by the intestine. Slowly, and with great caution, this must be broken up, and brought away bit by bit. The handle of a spoon has been recommended for this purpose, but I entreat my readers not to use it. Where pain is present, and life or death hang on the issue, there is no right to be any delicacy. An instrument of any kind introduced into such a part, and employed while the body is writhing about in agony, cannot be free from danger, and scarcely can be so used as to be effective. The finger is the quickest, the most safe, and the most effectual instrument; for we have it under our command, can guide it at our will, and with it take cognisance of all the circumstances presented. Even that must be employed gently, and this will be best done by the avoidance of haste. The surgeon is bound to be skilful, but he ought never to be in a hurry. Let all the time that can be occupied on such a matter be freely taken, and during the process, let the cries of the animal be attended to; any change of note will contain a warning which must not be disregarded. Without attending to that, the intestine might be ruptured, and death would then be certain.