Acute Intestinal Indigestion zvith Impaction. 199 



(hay), less so on grain, and less on green food or roots. The 

 animal paws, moves the hind limbs uneasily, looks at the flanks, 

 he may even kick at the abdomen, lie down and roll, rise, pass a 

 little manure or flatus, and seeming relieved may resume feeding, 

 until the next attack. The intermissions may last a few 

 minutes, a quarter of an hour or longer, and they gradually be- 

 come more prolonged until they disappear for the time. vSooner 

 or later, however, the obstruction becomes more complete and 

 the colic more severe and persistent. To the ordinary symptoms 

 of violent abdominal pain there are added symptoms which point 

 to bowel impaction or obstruction. There is a special tension of 

 the right side of the abdon;en, with flatness on percussion. 

 When down there is a tendency to sit on the haunches to 

 relieve pressure on the diaphragm and lungs. When standing 

 there is a disposition to stretch the fore limbs out forward and 

 the hind ones backward. Fseces may be passed at first in a few 

 small round balls at a time, but this soon ceases, and very little 

 or none can be obtained even by the use of enemas. The strain- 

 ing is usually so violent as to expel the enemata as .soon as intro- 

 duced. The hand introduced into the rectum can easily detect 

 the .solid impacted pelvic flexure of the colon pressing backward 

 into the pelvis or impinging on the right pubis. Another 

 common symptom is the frequent passage of urine in dribblets, 

 due to the irritation of the bladder by the pressure upon 

 it of the impacted colon during straining. In cases of this 

 kind the colon and caecum become tympanitic as finst shown 

 by a resonant distension of the right flank obliterating the hollow 

 in front of tlie ilium, and later by a similar condition of the left 

 flank. 



The abdominal pain is usually less acute than in simple spas- 

 modic colic or intestinal congestion. The face is less pinched and 

 anxious, the eye le.ss frightened, the kicking at the belly less 

 violent, and the lying down more deliberate and careful. Very 

 commonly the patient merely rests on his belly or side without 

 attempting to roll. 



Course. The disease may last six to twelve hours, or even as 

 many days before it ends in recovery or death. The colicy .symp- 

 toms usually increa.se, with the complication of dyspnoea when 

 tympany becomes well marked, hyperthermia in case of the 



