GASTRIC TYMPANY 59 



his case. Even should only one-half of them be exhibited, 

 a right understanding should be arrived at. 



There is another, and more grave condition, however, 

 which may so closely simulate tympanitic stomach as to 

 lead to serious error. I refer to twist of the double 

 colon, at either its sternal or diaphragmatic flexure, or 

 both. It is in the elimination of this possibility that the 

 greatest difficulty in the way of a correct diagnosis lies. 

 An animal in which that condition is present will, during 

 the first pains arising from it, exhibit signs that even the 

 most skilled may be excused for confounding with 

 flatulent stomach. There is the same quick pulse, 80 to 

 go, or 120; the same catchy, see-saw breathing; the 

 same signs of attempted eructation, and the same ingesta- 

 stained fluid running from the nose. Everything seems 

 in order, and the case is treated, as its symptoms appear 

 to warrant, for gastric tympany. 



Six to eight hours elapse, and the practitioner pays 

 another visit. He finds the symptoms no whit abated, 

 and recognises the case is a dangerous one. Even on 

 his first visit he had been struck by the intense redness 

 of the conjunctiva. This has increased now to a condi- 

 tion resembling that seen in the disease known as 

 enteritis, and the pulse has grown weaker and faster than 

 before. Still — and this is the circumstance that leads 

 first to wonder, and then to an alteration in the diagnosis 

 — the animal spends a great deal of his time in a re- 

 cumbent position. Reared upon his chest, he lies in 

 apparent half-comfort. Were it not for the redness of 

 the conjunctiva, and the peculiar catching sob that is now 

 taking place with each respiration, his position would 

 indicate ease. In other words, his pains, on a first 

 glance, would come under the category of ' dull,' and be 

 thus correctly referred to the colon. 



