Acute Intestinal Indigestion with Impaction. 203 



(hay), less so on grain, and less on green food or roots. The 

 animal paws, moves the hind limbs uneasily, looks at the flanks, 

 he may even kick at the abdomen, lie down and roll, rise, pass a 

 little manure or flatus, and seeming relieved may resume feeding, 

 until the next attack. The intermissions may last a few 

 minutes, a quarter of an hour or longer, and they gradually be- 

 come more prolonged until spasms disappear for the time. Sooner 

 or later, however, the obstruction becomes more complete and 

 the colic more severe and persistent. - To the ordinary symptoms 

 of violent abdominal pain there are added symptoms which point 

 to bowel impaction or obstruction. There is a special tension of 

 the right side of the abdomen, with flatness on percussion. 

 When down there is a tendency to sit on the haunches to relieve 

 pressure on the diaphragm and lungs. When standing there is 

 a disposition to stretch the fore limbs out forward and the hind 

 ones backward. Fasces may be passed at first in a few small 

 round balls at a time, but this soon ceases, and very little or 

 none can be obtained even by the use of enemas. The straining 

 is usually so violent as to expel the enemata as soon as intro- 

 duced. The hand introduced into the rectum can easily detect 

 the solid impacted pelvic flexure of the colon pressing backward 

 into the pelvis or impinging on the right pubis. Another com- 

 mon symptom is the frequent passage of urine in dribblets, due 

 to the irritation of the bladder by the pressure upon it of the im- 

 pacted colon during straining. In cases of this kind the colon 

 and caecum become tympanitic as first shown by a resonant dis- 

 tension of the right flank obliterating the hollow in front of the 

 ilium, and later by a similar condition of the left flank. 



The abdominal pain is usually less acute than in simple spas- 

 modic colic or intestinal congestion. The face is less pinched 

 and anxious, the eye less frightened, the kicking at the belly less 

 violent, and the lying down more deliberate and careful. Very 

 commonly the patient merely rests on his belly or side without 

 attempting to roll. 



Course. The disease may last six or twelve hours, or even as 

 many days before it ends in recovery or death. The colicy symp- 

 toms usually increase, with the complication of dyspnoea when 

 tympany becomes well marked, hyperthermia in case of the 

 supervention of enteritis, and signs of general peritonitis and 



