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All of the nutriments needed to keep the body in perfect condition should be given to a patient who is ill; in some manner he should receive the proper amounts of iron, salt, calcium, starch, protein, sugar and water. Intestinal sluggishness. This means not only that tympanites should not be allowed, but also that necessary laxatives should be given.
There were obstructing esophageal neoplasms about 10 1/3 inches from the teeth, which prevented vomiting. In reviewing the literature Wunschheim found only six cases of spontaneous rupture of the stomach. Arton reports the case of a negro of fifty who suffered from tympanites.
Quinine for the regular morning and evening doses, sulphonal and trional for insomnia, ether for injections in case of anemia after hemorrhage, morphine for delirium, citrite of caffeine for weakness of the heart, tincture of valerian for the tympanites, bismuth to relieve nausea and vomiting, and the crushed ice wrapped in flannel cloths for the cold pack in the event of hyperpyrexia.
The distention, I was informed, had been gradually coming on from the first, and he had been given morphine to control the pain from the first day of his illness. When they gave me this information I knew that the tympanites was due to narcotic paralysis, instead of coming from perforative, septic peritonitis, as the general appearance and symptoms indicated.
The diet should of course be sufficient, for the patient and proper for the disease, but any diet which causes a large amount of gas in the stomach, or tympanites, is harmful to the patient's circulation, to say nothing of any other harm, such as indigestion may do.
Paracelsus makes no mention of the tympanites as taking place after the attacks, although it may occasionally have occurred; and Schenck von Graffenberg, a celebrated physician of the latter half of the sixteenth century, speaks of this disease as having been frequent only in the time of his forefathers. Beginning of the Great Schism
Again, the opium masked the case dreadfully; for it produced vomiting at that stage of the case when there should have been no trouble with the stomach at all, and induced a tympanites that was mistaken for the same state brought on by peritonitis.
If this man had been subjected to daily examinations food and drugs, would he have presented the same symptoms! Indeed the tympanites alone would have killed him. Was his case diffuse peritonitis? No!
A patient may have pain with tenderness, fever and vomiting, and be very far from having appendicitis. There is a world of difference in the importance of pain, the range being from no danger at all to absolutely no hope. Tympanites may mean a very simple state or an absolutely hopeless state.
Third day: Temperature 100 degree F. at 9:00 a. m.; 101 degree F. at 5:00 p. m.; one-third of the tympanites gone; slept six hours; hungry and demanding food. I said, "No, you get no food until the bowels move." The ice was taken off the bowels; hot cloths were substituted.
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