86 COLICS AND THEIR TREATMENT 



parently rare disease, occurred within a month, and con- 

 sequently impressed me quite strongly. 



I must confess that during the lives of the patients I 

 did not locate the exact portion of large intestine af- 

 fected; and thought both cases to be impaction of the 

 great colon, but realized that they were atypical. Fortu- 

 nately, owing to certain extraordinary manifestations, I 

 conducted thorough postmortem examinations in both 

 cases, the results of which amply repaid me for the 

 time and labor involved. 



My observations during life and after death in these 

 two cases will, I feel positive, enable me to make an 

 early diagnosis, should I again meet with one of these 

 cases. As an excuse for my failure to differentiate cecal 

 from colonic impaction, I will say, that, while handling 

 the first I was unaware of the possibility of impaction of 

 the cecum, and in the second case I formed a strong 

 impression that the unusually long duration of the im- 

 paction was due to adhesions or deformities of the colon, 

 and failed to give weight to symptoms which I now 

 recall. 



The symptoms in my cases differ in some minor de- 

 tails from those in the cases chronicled by the above 

 writers. I will describe the course of the disease as I 

 have seen it, and attempt to draw conclusions. 



A Case of Cecal Impaction Fatal in Six Days 



Unfortunately I did not see the first case until eight 

 hours before death which took place on the sixth day 

 after the onset of the attack. Consequently part of this 

 description is history which by much questioning I have 

 tried to make complete in the important points. 



