370 Accuinulatiou of Feces in the Intestines. 



ease ends in recovery without having led to s}^nptonls of colic. 

 Fecal accnmulation in the small intestine causes sudden attacks 

 of colic and usually lasts one to two days. Obstipation of the 

 large intestine always lasts several days, even two to three 

 weeks (especially obstipation of the cecum), unless it is relieved 

 earlier by proper treatment. 



A recurrence of the attacks of colic is not infrequently ob- 

 served, either because errors of diet have not been corrected or 

 because the intestinal niuscularis has been weakened while the 

 obstipation lasted, or because the accumulated feces have not 

 been removed completely. The two latter circumstances are 

 particularly effective on account of anatomical conditions in 

 obstipation of the cecum ; and this form of fecal accumulation is 

 seen not infrequently in the form of recurring attacks (socalled 

 habitual chronic or periodic colic). 



Diagnosis. Retardation followed by cessation of defeca- 

 tion, the history of the case, and the usually mild attacks of 

 colic occurring at long intervals, the absence of general symp- 

 toms make a diagnosis of obstipation in the large intestine quite 

 probable ; however, only rectal examination can make the diag- 

 nosis absolute ; its differentiation from similar affections, and its 

 exact localization depend upon rectal exploration. Feces contain- 

 ing sand point to obstipation due to this (socalled sand colic), 

 and in this type the general symptoms usually come on sooner. 

 Valuable assistance in the diagnosis and prognosis may be ob- 

 tained by the quantitative determination of indican as proposed 

 by Bauer. It is absolutely impossible to determine the seat of 

 the obstipation from the behavior of the animals as suggested 

 by Klemm. 



The size and the firm consistency of the affected parts of 

 the intestines, which can be ascertained by rectal examination, 

 distingaiish the disease from various other forms of intestinal 

 occlusion, with the exception of stenosis or obturation of long 

 duration, or of paralysis of the rectum ; these can be differen- 

 tiated by the different nature of their onset and by the fact that 

 the site of the stenosis or of the obturating foreign body can be 

 felt from the rectum. In affections of the stomach and in ob- 

 struction of the small intestine, the contents of the large intes- 

 tines likewise become desiccated if the disease has lasted for 

 any length of time ; however, the large intestines are not dilated 

 by the desiccated feces but are diminished in diameter. 



Prognosis. If proper treatment is instituted in good time, 

 the great majority of cases end in recovery. The longer the 

 disease has lasted the firmer the stagnating intestinal contents 

 are, and the more dilated the obstipated intestines the less hope 

 there is to remove the obstruction. One also must always con- 

 sider the exact site of the obstipation, because if it is in the 

 small intestines or cecum, a fatal issue is comparatively fre- 



