Symptoms. 319 



the first portion of the duodenum are found between the pos- 

 terior surface of the liver and the posterior surface of the stom- 

 ach, which are now directed towards the head below or, on the 

 contrary, above the twisted esophagus, while the great curva- 

 ture is turned towards the right. The mesentery of the duo- 

 denum forms a tense string drawn between the riglit kidney and 

 the stomach and compressing the median part of the latter from 

 in front. The mesentery is drawn over the dilated stomach and 

 the dark red wall of the latter may be seen shining through it. 

 Upon cutting open the stomach, gas is discharged abundantly; 

 the mucosa is dark red ; the whole wall is infiltrated and edema- 

 tous. The dark red discoloration is sharply demarcated towards 

 the esophagus, but fades out gradually at the pylorus towards 

 the normal mucosa of the duodenum. The spleen is much en- 

 larged and curved in the shape of a capital U, blackish red in 

 color, the capsule is tense. The abdominal cavity usually 

 contains a hemorrhagic serous fluid. The liver is somewhat 

 displaced towards the right and is anemic. Occasionally there 

 may be signs of a beginning peritonitis. 



In the case reported hy Caroiigeau & Prestat, the abomasum of the 

 calf was twisted towards the right ; both openings were closed ; its wall 

 showed evidences of much congestion, the peritoneum was inflamed. 



Symptoms. The disease is characterized by a sudden attack 

 of abdominal pain, and by rapidly increasing bloating. The 

 patient stands motionless and apathetic on one spot and if 

 urged on, moves stiffly and carefully. The ingestion of food 

 and drink, and defecation cease; exceptionally there may be 

 intense thirst (Bonvicini), but the ingested water at once re- 

 turns through the mouth or nose. Gagging sometimes super- 

 venes, but vomiting does not occur; irritation of the fauces 

 causes retching, but no vomiting. The abdomen usually rap- 

 idly enlarges in all directions, in exceptional cases only slowly 

 (Bonvicini), it appears tense. The percussion sound is every- 

 where loud, occasionally of a metallic character with the excep- 

 tion of a dullness in the right hypochondriac region as large as 

 a hand, which is caused by the spleen which is here situated 

 behind the abdominal w^all (Cadeac). Palpation of the abdo- 

 men causes intense pain, particularly after the affection has 

 lasted a certain length of time ; one can feel a tense sac in the 

 abdominal cavity. Intestinal sounds are absent. 



As the abdomen gradually increases in size, difficulties in 

 respiration increase to attacks of suffocation; cyanosis be- 

 comes marked, the heart beat is much accelerated, hard; the 

 pulse becomes gradually weaker and finally it can no longer 

 be felt. 



The disease is of short duration, death ensues within 24 to 48 

 hours after the appearance of the first symptoms, as a rule in 

 consequence of suffocation. 



