later growth of the worm. The worm should never be dragged from the bowel if hanging from it, but an injection of soapsuds should be given to dislodge it. It is well to receive the bowel passages in a vessel of warm water, in order to ascertain the presence of the worm and prevent its breaking.

There are many other efficient and more powerful drugs for destroying worms, but they are not safely employed except under a physician's directions, and for this reason, and because mucus and other matter in the excrement are often taken for worms, it is always best to consult a doctor. Measures for preventing tapeworm include the destruction of all segments, meat inspection, and sufficient cooking of meats to kill the parasites.

CHAPTER III

Common Abdominal Pains

Remedies for Colic-Neuralgia of the Stomach-PeritonitisAppendicitis-Gallstone-Renal Disorders-Stoppage of the

Bowels.

COLIC; STOMACHACHE; BELLYACHE; INTENSE PAIN IN THE BELLY.-There are many diseases causing colic, or intense pain in the abdomen, which are considered in detail below, but in such conditions the first endeavor must be to relieve the suffering, and the following measures will be appropriate in all cases.

Treatment. Opium in some form is usually essential. Among its various preparations, morphine sulphate (grain one-sixth), laudanum or the tincture of opium 1 (ten drops), and paregoric1 (one and one-half tablespoonfuls), one should be given hourly in a little water, until the pain abates or three doses have been given, or, if the drug is immediately vomited, the dose may be repeated at once. Morphine injected under the skin with a hypodermic syringe acts more certainly and rapidly, but this can rarely be done except by a physician. Suppositories containing each one-quarter grain

1 Caution.

Dangerous.

Use only on physician's orders.

of morphine and one-quarter grain of extract of belladonna are useful, because they are made to be introduced into the bowel and cannot be expelled by vomiting. One should be greased and inserted into the bowel and repeated in an hour, if necessary, but opium must not be given at the same time, in any form, by the mouth. The inhalation of ether from a towel, folded into a cone and held over the nose and mouth, is harmless, providing the patient is not rendered wholly unconscious, and also the use of chloroform, if given with the same purpose. They may relieve severe pain until the preparation of opium has begun to act. Ether should be poured on the towel, about one tablespoonful at a time, and repeated every three to five minutes, the towel being kept close over the face. In very extreme cases chloroform should be given only in single drops on a handkerchief, held an inch or so from the patient's mouth, a fresh drop being allowed to fall on the handkerchief as soon as the previous one has evaporated. Twenty drops of chloroform, if swallowed on a little sugar, will sometimes give relief from pain, but chloroform should not at the same time be inhaled. The application of cloths, wrung out of very hot water and, if possible, sprinkled with turpentine and applied frequently to the belly, will prove of much service. Also a bag containing hot water-not more than half full to avoid weight-or large, hot poultices made of bread, Indian meal, flaxseed, or any of the cereals, may be employed. Rubbing the belly in the direction

of the large intestine, if it is not tender and is much swollen with gas, may afford great relief. Hot water, containing a tablespoonful of whisky or brandy, may be swallowed if there is faintness, but ordinarily with vomiting no food or drink should be taken, except the medicine, while the pain lasts. Sometimes assisting the patient in changing his position lessens the suffering. For the special causes of severe colic and the special treatment each demands, consult the following articles.

The more common disorders giving rise to severe pain in the abdomen which we will consider are intestinal colic, neuralgia of the stomach, appendicitis, peritonitis, gallstone colic, renal colic, obstruction of the bowels, and, in women, labor pains, coming at intervals with complete intermissions; and pain in young women at the time of monthly sickness or men

struation.

INTESTINAL COLIC.-Intestinal colic is commonly caused by eating some kind of indigestible food. Indulgence in cold, fermented drinks, as sold at the soda-water fountains, and spoiled and tainted food are frequent causes. Hysterical women or those suffering from other nervous disorders are likely subjects. Attacks generally begin with nausea and vomiting and sometimes belching of wind. Constipation has often existed before the attack. The pain, which is frequently so severe as to cause groaning, crying, panting, and faintness, with cold sweats, is felt generally

about the navel, although it may be in other parts of the belly and may shift about from time to time. Usually the suffering is somewhat relieved by pressure and if the patient lies on his stomach. In this respect intestinal colic differs from most of the other diseases, where pressure on the belly increases the pain. Occasionally in intestinal colic there is great sensitiveness to pressure, especially when the belly is distended with wind. The pain may last for hours or even days and varies in intensity. It sometimes extends to the back, thighs, loins, and even testicles. Hiccough, shallow breathing, and palpitation of the heart often accompany the attack. There is no fever, the temperature standing at 988 F., and the pulse is not rapid, being usually below 80. In this it differs from most of the other more serious diseases accompanied by severe abdominal pain.

Recovery is the rule; only very rarely does death occur in intestinal colic, and then because the pain is so excruciating that fainting and failure of the heart

ensue.

Treatment. The general treatment already given for colic applies to intestinal colic, but as soon as the patient can retain anything in his stomach it is wise to give either five grains of calomel or a tablespoonful of castor oil. During the attack the injection of one quart of hot soapsuds into the bowel, which should be repeated every half hour till the bowels move freely, will be advisable. Nothing but broths and thin gruels