The image contains the following text:
acute, though more often annoying and irritating. If they have
ever been induced to apply a mustard poultice to the seat of
pain, they dwell on the relief, great, though temporary, they
have experienced from it. The stomach, in most of the cases I
have seen, has not been irritable; it commonly retains and
digests the food ; but pain is frequently felt in the course of the
colon, in a period varying from an hour to two hours after eat-
ing. The bowels are at one time constipated, at another lax, in
the same person. Some are uniformly costive, others more
frequently loose ; but in all (and this is the characteristic mark
of the disease') there is a peculiar membranous, fibrinous, or
jelly-like matter discharged from the bowels. In some cases,
it is stringy ; in others, tape-like in its form ; in others, again, it
is in small masses, resembling fat or stiff jelly; while, in the
milder cases, it is more diffluent and gelatinous."
That tliis disease has, from want of proper and actual exami-
nation of the intestinal evacuations, frequently eluded observa-
tion, I know too well from my own experience, and that it has
consequently been maltreated does not admit of doubt. The
last thing the patient will mention, (if indeed he mention it at
all,) is the characteristic discharge. When the doctor directs
his or her attention to it, they will hesitatingly admit that they
may possibly have remarked it; nay, even when they are
informed that it appears with every stool, they will often fail to
discover it; and hence no practitioner should rest satisfied, when
lie has reason, from other indications, to suspect this affection,
till he has himself examined the fasces most carefully, partic-
ularly while separating the fluid from the solid matter. In the
former, as they are being poured off, he will rarely fail to dis-
cover flakes, or shreds, or even small masses; these, if dis-
covered, will lead, at future opportunities, to the detection of
larger and more unmistakable portions of this abnormal secre-
tion. To take the report of the appearances from the patient,
is, in too many instances, the surest way to deceive both him
and yourself. In addition to this, there is not unfrcquently
(but not always) a discharge of blood from the bowels, and
that, too, where no hemorrhoids can be detected. Almost uni-