CHAPTER XII 



SUBACUTE OBSTRUCTION OF THE 

 SMALL INTESTINES. 



Definition. — In spite of the fact that post-mortem 

 records have not yet described a case of obstruction of 

 the ' small intestines, I feel led, by the clinical evidence 

 I have obtained, to give it, or at any rate the possibility 

 of its occurrence, a place of description. Clinical evi- 

 dence, as I hope this chapter will show, offers for our 

 consideration a form of obstruction whose position in the 

 intestinal tract is certainly far forward in the double 

 colon. Whether further forward still, and obstructing 

 the small intestines, only future records will show. What 

 evidence is obtainable appears to point strongly to the 

 fact that obstruction of the duodenum does sometimes 

 occur, and that ' stoppage ' pains are not always to be 

 precipitously referred to the single or double colon. The 

 only argument against that statement is the one — ' post 

 mortem records have not shown it.' Purely negative evi- 

 dence, however, is seldom really satisfactory ; and I hope 

 that the symptoms hereafter described will substantiate 

 my statement that obstruction of the small intestines, 

 most probably of the duodenum, has sometimes to be 

 reckoned with. 



Causes. — Regarding the causes of colix;, I am afraid 



lO — 2 



