MEDICAL NOTES.

Auckland Star, Volume LXIV, Issue 88, 15 April 1933, Page 9 (Supplement)

MEDICAL NOTES.

COLIC ATTACKS.

DIFFERENT KINDS OF STONE,

BEFORE THE DOCTOR COMES,

(By PERITUS.)

You may awake in the night with a pain so severe that it is spoken of as "agony," and you must not assume that it is from the appendix, because there are other origins of s. pain similar in severity. There is colic of the bowel, of the gall bladder and of the kidney. The bowel pain may be no more than a temporary distention, or blockage, or a mass of undigested food. In any of these the pain may be unbelievably severe, and yet the cause not necessarily seiious. In biliary colic the pain is caused by the passage of a gallstone along a track too email for it. The stone is on its way to the bowel and when it arrives there it does not advertise the fact as it did the journey. These stones range from firm jelly to a faceted hard substance suitable for a miniature catapult. The harder and more angular it is the rougher the journey it makes, and the worse the pain. In stone from the kidney the stone books its passage to the bladder, _ and soft or hard it assails its owner with a sickening pain which wrings unwilling groans from the victim, who is for the time incapable of being interested in anything else. Remedies. Unfortunately nobody is willing to suffer in silence —even if able —until the offending substance and cause of the pain has gone on, and in each case somebody is called upon to do something, and do it quickly. The doctor seeks his morphia syringe and earns much gratitude, but the doctor may not b© near, and yet something must be done. In gallstone colic the pain is centred on the right side (sometimes reflected to the left) and may send shooting twinges through to a space below the right shoulder blade. The muscles over the right side are hard and tense, and there is often shivering, sweating, vomiting, and a feeble pulse. A hot bath may bring some relief, but more certain and convenient are hot fomentations (pads of flannel wrung out of very hot water) or poultices of bran, bread or linseed meal. The patient may drink freely of hot water, and the bowel should be emptied as quickly as possible. In kidney colic (kidney stone) the pain is. abdominal, and in the loin of the affected side. Here again the hot bath is useful, also hot applications, and plenty of alkaline fluid by the mouth (bicarbonate of soda and water) if vomiting does not prevent this, and here again quick emptying of the bowel is an advantage. x ' In the Doctor's Absence. Caution must bo used in giving aperients, lest an intestinal blockage or inflamed appendix is the cause of the pain, and an aperient may then increase the danger, although some authorities permit one dose of castor oil even in appendicitis cases. Intestinal colic is the least easily traced to its origin, but hot fomentations are harmless, comforting, and often give immediate relief. In all these cases when diagnosis is not possible and no medical aid is near, there io one useful remedy for the pain — Collis Browne's chlorodyne, which, in doses of thirty drops, is an anodyne, and may keep things quiet until a doctor is called. In children it is usual for the sudden abdominal pain to be due to wrong or undigested food, and, apart from the offending appendix, two gra : us of calomel powder and a ten-minuto sitting in hot water, waist deep, is an efficient routine. -The old edition of,"Advice to a Mother," by Dr. Pye Chevasse —the most useful and reliable book for mothers ever printed—was getting out of date and a trifle old-fashioned, and a new edition was published. Unfortunately the owners placed the revision in the hands of a man who feared to give mothers too much freedom to act for themselves, and he struck out all the prescriptions and paragraphs of medical advice, and substituted, throughout the book, the words "Send for the nearest doctor," a quite useless hint to thousands of families far from town and in need of knowledge of immediate usc» ,D ela y is very often dangerous, and a quick attention to some homely treatment is frequently better than a late arrival (sometimes too late) at hospital. There is much which can be said in a book that is quite unsuitable for the pages of a newspaper, and Dr. Pye Chevasse wrote to mothers in the simplest language, almost beyond misunderstanding. [Note. —The three elderly gentlemen of Onchunga; who asked for a special article here, selected a subject that is one of those barred from these columns, not only because of its unsuitability, but because the symptoms they wisli explained may arise from several different causes, and any published advice might be misleading. Probably these cases arei purely surgical.]