SUBACUTE OBSTRUCTION OF THE DOUBLE COLON 91 



tration of aloes, we ought rather to stay and ask our- 

 selves : ' Can we by any other means put the tetanized 

 wall into a state approaching its normal condition, and 

 so enable it itself to deal with the offending obstruction?' 

 I think we can, and, reserving my reasons for so saying, 

 will conclude my remarks on this question by stating 

 that, in my opinion, it is the tonic spasmodic seizure 

 of the bowel itself which is the actual condition we are 

 called upon to treat in obstructive colic. 



4. What part of the animal system is it best to operate 

 throttgh — the digestive or the nervous ? Or should our 

 attack he directed mainly against the offending substance itself ? 

 The whole crux of the argument concerning the treat- 

 ment of obstructive colic lies in the answer to these 

 questions. For my own part, I believe that the treat- 

 ment of the nervous division of this ailment should 

 receive our almost undivided attention ; and I further 

 believe that the administration only of drugs that 'act 

 wholly or mainly on the digestive tube itself, and not 

 on its nervous supply, are unproductive of good, if not 

 altogether harmful. Remember, we cannot depend on 

 the physiological action of the drug being sure to ensue 

 in this case. We are putting our drug into contact with 

 a diseased organ, and must not expect that organ to 

 take up, assimilate, and respond to that drug as the 

 same organ would do in health. In this case the disease 

 of the organ is its atony, spasm, or paralysis. Relieve 

 that, and the bowels will relieve their impaction them- 

 selves. 



Intestinal movements are dependent on the ganglia of 

 Auerbach's plexus, situated between the longitudinal 

 and inner circular layers of muscle. Secretion is believed 

 to be influenced by Meissner's plexus, lying in the sub- 

 mucous coat. Both of these ganglia, however, are con- 



