358 THE HOESE. 



cases of supposed enteritis, and have uniformly found signs of 

 inflammation of the serous investment, sometimes implicating the 

 muscular fibres beneath, and often extending to the peritoneal 

 lining of the walls of the abdomen, but I have never yet seen 

 marks of inflammation in the muscular tissue without their serous 

 covering being affected to a much greater extent I believe there- 

 fore that the distinction is erroneously founded, and that, theoreti- 

 cally, the same definition should be made of the two diseases as is in 

 use by human pathologists, though practically this is of little im- 

 portance. There is no well made out inflammation of muscular 

 tissue (except that of the heart) in which the symptoms are so 

 urgent, and so rapidly followed by a fatal issue as in the latter stages 

 of the disease described by Mr. Percivall under the head enteritis, 

 as follows: — 'The next stage borders on delirium. The eye 

 acquires a wild, haggard, and unnatural stare — the pupil dilates — 

 his heedless and dreadful throes render approach to him quite 

 perilous, he is an object not only of compassion but of apprehen- 

 sion, and seems fast hurrying to his end — when all at once, in the 

 midst of agonizing torments he stands quiet, as though every pain 

 had left him and he were going to recover. His breathing becomes 

 tranquillized — his pulse sunk beyond all perception — his body 

 bedewed with a cold clammy sweat — ho is in a tremor from head 

 to foot, and about the legs and ears has even a dead-like feel. The. 

 mouth feels deadly chill — the lips drop pendulous, and the eye 

 seems unconscious of objects. In fine, death, not recovery, is at 

 hand. Mortification has seized the inflamed bowel — pain can no 

 longer be felt in that which a few minutes ago was the scat of 

 most exquisite suffering. He again becomes convulsed, and in a 

 few more struggles less violent than the former he expires." 

 Analogy would lead any careful pathologist to suppose that such 

 symptoms as these are due to some lesion of a serous and not a 

 muscular tissue, and, as I before remarked, I have satisfied myself 

 that such is really the case. I have seen lymph, pus, and serum 

 effused in some cases of enteritis, and mortification extending to a 

 large surface of the peritoneal coat in others, but I have never 

 examined a single case without one or the other of these morbid 

 results. It may be said that so long as the symptoms are correctly 

 described their exact seat is of no consequence ; but in this 

 instance it is probable that the ordinary definition of enteritis as an 

 inflammation of the muscular coat may lead to a timid practice in 

 its treatment, which would be attended with the worst results. I 

 have no fault to find with the usual descriptions of the two 

 diseases, or with their ordinary treatment, but I protest against 

 the definition which is given of them. 



An examination of the cause of inflammation of the bowels 

 is the only means by which the one form can be distinguished 



