Symptoms. 369 



the entire intestinal tract, the amount of indiean became diminished be- 

 low normal, but it remained high if the cecum could not be evacuated, 

 even if diarrhea had been produced. 



The symptoms of obstipation in the small intestines vary 

 from those in obstipation of the large intestines since they come 

 on suddenly, within a few hours after food ingestion, or directly 

 after the latter, if the duodenum is involved. The symptoms of 

 colic are decidedly more marked, sometimes quite severe, and 

 a stretched position of the animals, as in urinating of male 

 horses, is observed. Defecation ceases within a few hours. Rec- 

 tal examination reveals the extended ileum as a smooth cylin- 

 drical mass the size of an arm, situated in the plane of the pos- 

 terior pole of the left kidney and to the right of the vertebral 

 column running from al)Ove obliquely downward and backward 

 and to the right, or on the contrary from below on the left up- 

 wards and to the right towards the base of the cecum and con- 

 tinuous with the latter. The obstructed duodenum can likewise 

 be felt as a cylindrical smooth body, the size of an arm, extend- 

 ing immediately behind the anterior root of the mesentery in a 

 curved direction from the right to the left and adherent to the 

 mesentery only by a short band. 



In contradistinction to what happens in obstipation of the 

 large gut, acceleration of the pulse and respiration appear one- 

 half day or sooner after the occurrence of obstipation of the 

 small intestine. This is olmously due to a secondary dilatation 

 of the stomach or to early inflammatory changes of the mucosa, 

 the pulse in particular rising to sixty and more per minute 

 even on the first day of the disease. The appetite is completely 

 suppressed. 



Complications are not at all rare in either form, but are 

 more common in obstipation of the small intestine. In the latter, 

 that is, in one-third to one-half of the cases, secondary dilata- 

 tion of the stomach (see page 297) occurs, although this condi- 

 tion is not at all rare in obstipation of the large intestine. Dila- 

 tation of the stomach may lead to rupture of the stomach. Rup- 

 ture of the intestines, which is toleral)ly common in obstinate 

 and unyielding intestinal obstipation and which always occurs 

 in very extensive fecal accumulation in the cecum, like rupture 

 of the stomach, leads to collapse (see page 301), or if the tear 

 is not very large and the shock has not been too great, it will 

 subsequently be followed by general acute peritonitis. A not 

 infrequent complication in obstipation of the small intestines is 

 enteritis. 



Course. Obstipation of the large gut develops, as stated, 

 very gradually; restlessness sets in only after a few days and 

 the condition becomes worse by and l)y. The patients, however, 

 are more or less dull during the whole course of the disease. 

 Cases are seen occasionally where, after several days, the dis- 



