SUBACUTE OBSTRUCTION OF THE DOUBLE COLON 93 



consequently, if atony of the small intestine exists, it 

 may never reach the position in which its action will be 

 the most marked. 



5. It needs to be saponified and emulsified by bile 

 before its prompt solution can be counted upon. 



These last two reasons may be considered a little more 

 in detail. It is they that have already made me refer to 

 the action of aloes as ' mechanical.' In face of state- 

 ments Nos. 4 and 5, no one will dispute that two purely 

 mechanical processes have to be gone through before we 

 can confidently calculate on a dose of aloes creating a 

 purge. It has to pass almost passively through the small 

 intestines before it can reach the large, and it requires 

 also to be mechanically mixed with bile before its solu- 

 tion can be expected. Unfortunately, in subacute 

 obstructive colic these very two processes that are 

 necessary for the prompt action of aloes are not at 

 all likely to come about. Regarding the first, I have 

 already pointed out that there is very little movement of 

 the bowels in this form of colic ; consequently, the drug 

 may remain almost stationary in the stomach, or at 

 the most gain the first few feet of the small intestines. 



With regard to the second process comment is well- 

 nigh useless. In subacute obstructive colic there very 

 frequently is considerable jaundice and torpidity of the 

 liver, in which case the aloes cannot act, or, to say the 

 least, its action is most certainly delayed, owing to the fact 

 that the bile necessary for its prompt emulsification 

 and solution is deficient or altogether wanting. 



6. Finally, in the horse there is always a danger 

 of superpurgation, followed by enteritis, laminitis, or 

 possibly death. This ought never to be overlooked. 



I am sure that every practitioner who has been in the 

 habit of exhibiting aloes in this disorder must have 



