73 COLICS AND THEIR TREATMENT 



instances the walls give way to the stretching and rup- 

 ture occurs. Dilatations follow stomach colics in which 

 there is little or no bloating in the bowels or when the 

 bloat in the bowels is suddenly relieved by evacuation of 

 the gases with the trocar and canula. As long as the 

 stomach is pressed upon by bloated bowels its walls are 

 supported against stretching or rupture, but when bloat 

 is absent or is relieved it distends in a backward di- 

 rection and either stretches into a serious dilatation or 

 else gives way entirely. It is therefore important in 

 treating overwhelmed stomachs to relieve the distention 

 by catheterization and then if necessary attend to the 

 gases in the large bowels. To reverse these operations 

 is hazardous. 



Every bad case of acute indigestion, impaction and gas- 

 tritis is followed by more or less dilatation with which 

 the surgeon in charge should reckon. In the vigorous 

 subject, given prompt treatment of the proper kind, the 

 stretched organ almost immediately resumes its normal 

 state and is ready to functionate in the normal manner; 

 in others the reaction requires several days and in some 

 it runs rapidly to a fatal end or leaves the stomach a 

 prey to frequent similar attacks and the patient a victim 

 of chronic indigestion. 



In order that I may not be misunderstood I should 

 mention here that we use the phrase "dilatation of the 

 stomach" to designate exclusively the stretched stomach 

 that does not immediately contract after the material 

 engorging it has been removed. The term is used by 

 some, notably by Hutyra and Marek, as synonymous 

 with engorgement of the stomach, whether the organ is 



