An Account of an Iliac Passion, from a Palsy of the Large Intestines; Communicated to Dr. De Castro, F. R. S. Translated from the Latin, by Tho. Stack M. D. F. R. S.

XVI. An Account of an iliac Passion, from a Palsy of the large Intestines; communicated to Dr. De Castro, F. R. S. Translated from the Latin, by Tho. Stack M.D. F. R. S. Read Feb. 21. 1750. A MERCHANT, aged seventy, who had been accustomed to hardships from his infancy, was, for the last six years, very subject to rheumatic pains; but, looking on his disorder as the effect of old age, he rejected all medical advice. In these circumstances it happened, that he was suddenly set upon by a party of soldiers, who, with severe threatnings, turned him out of his house, and took possession of it: which so terrified him, that he was seized with a violent belly-ach; and his agony so overpower'd him, that he fell on the ground half-dead; and at the same time he voided blood by the anus. When his fright and grief for the loss of his substance were over, he return'd to his usual way of life, and was much subject to the gripes all the ensuing winter, which he took no care of. During this time, he suffer'd much from costiveness, till March 1747, when he was seized with severe pains about the navel; and tho' he had clysters of several sorts given him, not one of them could be made to pass. He was feverish and thirsty, with a white moist tongue, and could not sleep. He was blooded as much as he could well bear; and the blood did not appear inflammatory. He was treated with laxative medicines, antiphlogistic fomentations, and every thing thing, that could be thought proper, to ease the gripings, and give a free passage: but nothing took effect for seven days together. On the eighth he began to break wind, retain the clysters, discharge some little faeces, and to sleep, tho' not quietly; and, on the ninth, to make turbid urine. But these promising appearances were but of short duration; for, on the eleventh, his belly was so bloated, that he seem'd tympanitic; and an acute pain, which he had in the hypogastric region, darted up towards the midriff on the right side: and now the mucus of the intestines came away with the clysters. He had bad sweats, and made foul urine, without sediment. On the 15th a consultation was held; and, as his thirst and fever were abated, and the medicines hitherto prescribed for opening a passage, and taking down the swelling of the belly, which seemed ready to burst, had proved ineffectual, it was agreed to make him swallow six ounces of crude quicksilver, with oil of sweet almonds, and syrup of violets; and, soon after, to throw in several purging clysters. In nine hours a passage was opened, and he voided much black liquid excrement, without the least grain of quicksilver, tho' very carefully sought for. A little after that, he vomited much; and, in what he threw up, there plainly appear'd excrements, and globules of mercury. This was soon follow'd by thirst, a little slow fever, very troublesome gripings, no sleep, red high-colour'd thick urine, in very small quantities, breaking of wind without any ease, vomiting of every thing he took, great weakness, and partial tial sweats in the forehead and breast. Under these symptoms he languish'd to the twentieth day, and then died. The appearances, upon dissection, were these: The omentum was consumed; but the colon was inflamed in several places, and so distended with wind, that it nearly filled the whole abdominal cavity. Its ligaments or bands were so thoroughly effaced, that there was not the least sign of them remaining. In like manner, the cæcum was so vastly stretched, as to take up the whole capacity of the pelvis; and that part of it, which is touched by the thick gut, was gangrened, and perforated with a small opening. Having clear'd it of the excrements, there were no internal rugæ at the insertion of the ileum, nor any traces of the valve of the colon, or of its braces, to be observed. For it was quite smooth on the inside, as well as the colon, by the destruction of the cellules, which it has in a natural state. The quicksilver was dispersed all over the cavity of the abdomen, in such quantities, that it was easy to perceive, that none had been discharged by stool. Every thing else, contained within both the cavities, was in its natural condition.