96 COLICS AND THEIR TREATMENT 



colon without entering the cecum. To accomplish this, 

 the firm muscular nozzle like extremity of the ileum 

 would have to be carried upwards and into the entrance 

 of the colon, there to discharge its solid contents. 



I will go one step farther and suggest that if the above 

 be true, and I have reason to believe that it is, may 

 not this muscular extremity of the ileum, or so-called 

 ileo-cecal valve, possess a selective power on solids, 

 semisolids and fluids similar to that of the esophageal 

 pillars of ruminants? 



This would enable the ileum to discharge its coarse, 

 practically indigestible solids directly into the colon and 

 its fluids containing the great majority of the soluble 

 and diffusible matter into the cecum where it could be 

 quickly taken up by the blood. 



Presuming this to be possible we may assume that in 

 the absence of water in sufficient quantities to keep the 

 cecum at its normal status of distention, collapse of its 

 walls would occur and disturbance of this presumed se- 

 lective power of the ileco-cecal valve might result and 

 solids be discharged into the cecum until this reservoir 

 became distended. 



Following this, whatever diffusable fluids were mixed 

 with these solids would be quickly taken into the blood 

 in the natural way and a firm dry impaction of the cecum 

 would be the result. 



The very form of the cecum, with its outlet close to 

 and higher than its inlet, makes it impossible for this 

 organ to get rid of a large solid mass, in any manner 

 that I can at present conceive of. 



When we have an impaction of an intestine through 



