Before attempting to direct the treatment for these cases

Before attempting to direct the treatment for these cases

Before attempting to direct the treatment for these cases

Before attempting to direct the treatment for these cases, it is necessary the nature of the affection should be fully explained. The enlargement, to which attention is at first solely directed, is always of secondary consideration. The dropsy is merely a symptom indicative of the loss of tone of the adjacent parts, of which the rectum is by far the most important. If this circumstance be not observed, but the swelling be treated as if it was all the practitioner had to contend with, he will in the end learn his mistake. The intestine loses its tonicity; it no longer has power to contract upon or to expel its contents; it becomes paralysed, and the dung consequently accumulates within it, distending it, and adding to its weakness by constant tension. The rectum at length retains no ability to perform its function; but the sphincter of the anus, or the circular muscle that closes the opening, appears to gain the strength of which the intestine is deprived. It contracts, and thus shuts up the fæces which the rectum cannot make an effort to dislodge; and in this circumstance the physiologist sees evidence of the sources whence the different parts derive their contractility. The rectum, like the other intestines, gains its vital power from the sympathetic nerve, or that nerve of nutrition and secretion which presides over organic life. The muscle of the anus, on the other hand, is influenced by nerves derived from the spinal column; and thus, understanding the two parts obtain their motor power from different sources, the reader will comprehend how one can be incapable of motion while the other is unaffected, or rather excited; for the presence of the retained dung acts as an irritant, and provokes the anus to contract with more than usual vigor.