406 



Obstruct iuu of the Mesenteric Arteries. 



pulse boc'Oine accelerated and forced (in bloating of the large 

 intestine the respiration is interfered with by the displaced 

 diaphragm. The temperature [Fig. 41 j is normal at the onset; 

 it rises soon, however, in consequence of the appearance of 

 complications [peritonitis, general sepsis, enteritis].) 



While restlessness persists, becomes 

 less, or even ceases entirely in the fur- 

 ther course, the pulse becomes gradual- 

 ly weaker, the respiration becomes more 

 and more forced and difficult, uncon- 

 sciousness increases, tremor of the mus- 

 cles and staggering set in, finally the ani- 

 mals fall down and the end comes with 

 convulsions. 



In rare cases the severe type of the 

 disease takes a protracted course. If the 

 circulatory disturbances persist for sev- 

 eral days Avithout reaching a very high 

 degree, the absorption of intestinal 

 gases will not be very much interfered 

 with, and there is neither an abundant 

 exudate, nor particularly active fermen- 

 tation of the intestinal contents. Since 

 the nutritive disturbances of the intes- 

 tinal mucosa do not attain a very high 

 degree, a diffuse peritonitis does not de- 

 velop, and complete paralysis of the 

 bowel either appears verv late or not at 

 all. 

 In cases of this kind restlessness may be observed, but 

 rarely unnatural positions. The circumference of the abdomen 

 is increased not at all or only very moderately. The intestinal 

 sounds, which are at the onset very marked and of long duration, 

 later on become less frequent without, however, ceasing entirely, 

 therefore the expulsion of feces and gases is not entirely sup- 

 pressed. The feces are sometimes hemorrhagic and fetid, and 

 now and then intestinal gases are expelled sparingly. Rectal ex- 

 amination sliow^s insignificant or moderate bloating, and in the 

 further course occasionally the accumulation of more abundant 

 masses of firm feces. Pulse, respiration and temperature show 

 some deviation from the normal without, however, reaching 

 anything like what is observed in the severe type and in cases 

 with a rapid course (Fig. 42). It also may happen that the 

 temperature rises considerably at the beginning, and that pulse 

 and respiration become quite markedly accelerated, to decrease 

 considerably later on (Figs. 41 and 42). The sensory functions 

 are clouded, the appetite is suppressed or poor. 



The clinical jiicture lasts sometimes for several days, ex- 

 ceptionally over a week. Friedberger ol)served in one case a 

 duration of twenty-two days; Kremp one of twenty-one days; 



Fig. 41. Fever curve in tlirou 



bosis of the mesenteric 



arteries. 



