188 ABDOMINAL INJURIES. 
Before strangulation can possibly occur, the mesentery must be sun- 
dered. It almost always happens to a portion of the small intestines. 
The bowel, freed from its support, soon involves itself with numerous 
complications; or the rent membrane may twine round a knuckle of the 
gut. 
A ENUCELE OF INTESTINE STRAN- 
GULATED BY THE RUPTURED RUPTURE OF THE SMALL 
MESENTERY. INTESTINES, 
The above illustration, however, shows one of the simplest forms in 
which the accident can possibly take place; but no person, however 
acute, could distinguish between strangulation from rupture of the intes- 
tines. The last generally occurs upon the smaller bowels, and happens 
to the interspaces upon the superior portion of the tube, between the 
vessels which nourish the digestive canal. The ingesta is consequently 
forced between the layers of the mesentery. The most intense anguish, 
inflammation, and death are the consequences. 
Calculus or stone may be present, either in the stomach or in the 
canal. Those in the stomach are of small size; those within the intes- 
tines may attain the weight of more than 
twenty pounds. Those of the stomach are 
always smooth, as also may be those of the 
bowels. To the intestines, however, there 
are common three kinds of, or differently 
composed calculi: the triple phosphate or 
the earthy; one formed of the minute hairs 
which originally surrounded the kernel of 
mMCALCULUS AAS QuIETED, Ware aNorarn the oat; and another composed of dung, 
FIRMLY GRASPED 1? as To nUPTUREIx, held together by the mucous secretion of the 
aaa bowel. Any of these calculi may, as the 
size increases, gradually stretch the intestine; thus forming a living sac 
within which the stone abides. While it remains there, the food passes 
over it and no injury is occasioned. But by any movement it is likely 
to be dislodged and thrown into the healthy channel. There it is firmly 
grasped with such force as to produce rupture of the intestine, and the 
hold is only relaxed after inflammation has ended in mortification and in 
death. The bowels, in trut», are impacted by calculus. The passage 
