SYMPTOMS. 667 



subject and other animals, to be of more frequent occurrence 

 in the very young than with such as have reached maturity. 

 Although commonly it is only a few inches of the bowel which 

 is passed Avithin the continuation of the tube, instances are 

 recorded where the extent of the invagination occupied several 

 feet. Like other states of entanglement, this is in all proba- 

 bility a condition not occurring of itself and apart from some 

 other abnormality, but merely developing as a concurrent 

 symptom or occasional feature during the progress of several 

 disturbances or textural changes. 



Symptoms. — The clinical phenomena indicative of obstruction 

 either from intestinal concretions or mechanical displacement 

 are somewhat varied, not diagnostic ; rather, upon the Avhole, 

 such as are common to many conditions of disturbed function, 

 or to organic change afiecting the organs of the abdomen, par- 

 ticularly the bowels. One class in particular, developed in 

 connection with accumulations either stercoraceous or of vari- 

 ously-composed concretions, the result of specialities in dieting, 

 are as a rule gradual in growth, or rather the symptoms are of 

 an intermittent character. The others are oftener of sudden 

 occurrence, starting into existence without premonitory warn- 

 ing, or in conjunction with some derangement of abdominal 

 organs associated with pain, as in ordinary colic or states of 

 inflammatory action. 



In both classes of cases, but to a greater extent in the former, 

 the history of the case will help us somewhat. Constipation 

 or irregularity in the amount and character of the discharges, 

 with recurring attacks of colic, are characteristic of obstruction 

 from accumulation of adventitious material of whatever sort ; 

 while, Avhere entanglement or mechanical displacement is the 

 cause, constipation is not the most attractive feature, rather 

 the violence and continued nature of the abdominal pain indi- 

 cative of inflammatory action. 



In these latter in certain forms, as when the great bowel is 

 twisted upon itself, it is occasionally possible by examination 

 through the rectum to detect the entanglement in the form of 

 a distinct cord, and through the altered position of the double 

 colon. With such, also, there is often considerable tympany, 

 borborygmus, and ultimately stupor from disturbed cerebral 

 function. 



