RUPTURE OF INTESTINAL WALLS. 1 89 



tion, and to this end \ve cannot do better than quote Professor 

 Robertson's lucid description; he saj's: "The symptoms which 

 iiadicate the fatal termination of disturbed function are neither 

 uniform nor diag'nostic. In some the occurrence of the lesion 

 seems to be followed by rapid collapse; in others it would appear 

 that life may be prolonged for many hours. With one we may 

 have mitigation of the distressing features previously existing; 

 with another, on the contrary, all these may suffer aggravation. 

 When occurring in association with impaction or unnatural rela- 

 tion of ingesta in the colon, together with considerable distension 

 from gases in the bowels, in which cases we often have restless- 

 ness and much straining, the occurrence of the lesion is naturally 

 followed by relief in the symptom of restlessness, and a subsid- 

 ence of the straining, comparative calm and quietness being the 

 condition succeeding rupture until death. In all with the com- 

 pletion of the rupture I have observed that exhaustion is a feature 

 rapidl}'^ developed; and that although relief from pain seems to 

 have been obtained at once and unexpectedly, there is a haggard, 

 anxious expression of countenance, a frequent and small pulse, 

 steadily becoming more rapid and at last imperceptible, patchy 

 perspiration, short, catching respiration, gradually a disinclina- 

 tion and inability to move, the animal balancing itself as it were 

 on the limbs until the very last. Whenever cases of colic, marked 

 by impaction of the bowels, with or without much distension, ac- 

 companied with straining, suddenly exhibit cessation of the pain 

 and straining, together with the appearance of much exhaustion 

 and other symptoms indicated, we have some grounds for fearing 

 rupture of some part of the intestinal wall." 



In face of the several suggested doubts as to the possibility of 

 recognizing the absolutely diagnostic sj-mptoms of intestinal 

 rupture, we can but earnestly commend the practice of persistent 

 treatment right up to the end, even in the most suspicious cases; 

 the remedies to be used being those suggested under colic accord- 

 ing to the totality of the symptoms. 



