SUBACUTE OBSTRUCTION OF THE PEL VIC FLEXURE 135 



particular form of colic speedy relief need not be looked 

 for. Quite confidently he may predict that some eighteen 

 to twenty-four hours must elapse after administration of 

 the purgative before cessation of the pains may be ex- 

 pected. 



Should the case linger longer than this, which in an 

 aged animal it is very apt to do, I have found the patient 

 to derive great benefit indeed from hypodermic doses of 

 ether, given in sufficiently large doses to maintain the 

 flagging energies of the heart. It is astonishing how 

 soon the drug, administered in this way, exerts its effects. 

 The irregular circulation is almost immediately equalized; 

 the pulse becomes somewhat slower, but stronger and 

 fuller; and at the same time action of the bowels is 

 certainly promoted. In fact, the best way in which one 

 can sum up its effects is to use the comprehensive 

 expression that it * gives tone ' to the system generally. 



Next, as to the administration of eserine. So far as 

 my own experience goes, I may say at once that in 

 obstruction of the pelvic flexure I have found it unwise 

 to exhibit this drug in the early stages of the case. Had 

 that not been so, I should have mentioned it before. 

 We have here an obstruction within easy reach of the 

 hand, the changes in the consistency of which can be 

 noted hourly ; and it seems a far more desirable thing, 

 to my mind, to wait until the administered medicines 

 have effected some degree of softening therein before we 

 push the bowel to extreme efforts to dislodge it. Given 

 earlier, it is productive of acute pain, and with no bene- 

 ficial result, so far as one can see, to the patient. 

 Directly, however, one is able to detect some tendency 

 on the part of the obstruction towards softening down, 

 then the eserine may be administered with the happiest 

 results. 



