106 COLICS AND THEIR TREATMENT 



condition may last several days, one attack of pain fol- 

 lowing another, and death resulting from toxemia, en- 

 teritis or torsion. The temperature, pulse, peristalsis and 

 conjunctiva are important warning signals to consider in 

 this regard. Under proper treatment, fully 95 percent 

 of the cases of impaction of the small bowels recover. 



Impaction of the Large Bowel. — In this condition the 

 feces accumulate in either the cecum or colon (pelvic 

 flexure, stomach-like dilatation) or in the rectum. These 

 may each be briefly considered. 



Cecal Impaction — Chronic impaction of the cecum is 

 commonly the result of an organic change in the wall 

 of the bowel. This change consists in the gradual dilata- 

 tion which induces impaction and as a result hypertrophy. 

 In time paralysis follows. The dilation becomes perman- 

 ent and impactions frequent. This form of colic is usu- 

 ally chronic, occurring intermittently, and unless relieved 

 takes a lethal termination. Usually toxemia, enteritis or 

 rupture of the cecum with peritonitis causes death. 



Cecal impaction can only be diagnosed by rectal palpa- 

 tion. In the region of the upper right flank may be felt 

 an enlargement of about the size of a man's head. The 

 enlargement is round, surface smooth and is not sensitive. 

 Sometimes the bands of the cecum may be felt on the 

 surface. The consistency of the swelling varies. It is 

 sometimes quite soft, doughy, retaining finger imprints; 

 at other times it is firm and hard. The fixed position of 

 the enlargement, its size and location in the tipper right 

 region of the flank usually makes the diagnosis not diffi- 

 cult. Error would be possible only in case there was 

 impaction with displacement of the lower left colon, the 



