There is, however, a stronger measure than merely heating the back and cooling the front in this way. The patient may be put at once into a sitting bath or small tub, and a panful of cold water poured or dashed on to the bowels; they then contract so powerfully, and shorten themselves so much, that all invagination, as it is called, is made to cease instantly. We should be disposed to try the mildest method in the first instance, unless the case is one in which the lock in the bowels had just taken place. Then it might be well to dash the pailful of water on so as to put all right at once, and afterwards simply to apply such remedies as would tend to prevent a recurrence of the evil.
It is, however, usually the case that the distress has lasted some time before an opportunity of doing anything occurs, inflammation, more or less, has set in, weeks may have passed, and blundering treatment may have done great mischief. Then it is safe to use the heat at the back, and frequently changed cold cloths in front, so as to reduce the inflammation, and contract the bowels more slowly, so as to remove the obstruction. When these have been used for some time, if the obstruction is not removed it will be well to resort to the stronger measures. Nothing is more beautifully simple than the ordinary action of the bowels. The healthful movement is like that by which an earth-worm moves along the ground: so long as the tube is thus moving its contents onward, by contraction and expansion, no part can pass inside or outside that which is before it; but when one part loses nervous tension, and expands without contracting quickly enough, the part behind it tends to worm itself into it, and a "knot," as it is sometimes called, is formed. No possible instrument can reach it except by cutting the body outright, but the action of cold is so powerful in contracting the tube that the "loop," as it is also called, is drawn out, and the right state of things is produced. It is important to remark that there are glands near the lower bowel that swell and form tumours. The cold applications reduce these very speedily to their usual size, and if their swelling is an obstruction, it is soon removed. But it is the lock in the tube itself that is the real malady of which so many die, and with which so many more narrowly escape.