240 THE COMMON COLICS OF THE HOUSE 



those instances, not infrequent, where cases of intestinal 

 impaction linger on for longer than a week, sometimes 

 for so long as fourteen days, and then recover. All of 

 these I have hitherto judged to be cases of obstruction of 

 the small intestines (see Chapter XII.). One is now 

 tempted to ask : ' May not some of these have been cases 

 of cffical impaction — cases where the caecum has for- 

 tunately managed to discharge its abnormal contents?' 



It is just possible. 



However, we can only prove this by first accustoming 

 ourselves to diagnose cases of cascal impaction by rectal 

 exploration. When we are able to do this, to definitely 

 assure ourselves that we have an impacted caecum, and 

 subsequently to verify that diagnosis at post-mortem, we 

 shall be in a position afterwards, if these cases ever do 

 end in recovery, to give a logical and indisputable account 

 of some of such as have so ended. 



Further, when we are able to recognize these cases, 

 and to know better the symptoms attending impaction of 

 this portion of the intestinal tract, we may be able, first, 

 by seeing such a set of symptoms, and, secondly, by 

 putting the caecum out of the reckoning by means of a 

 rectal examination, to come to a fuller understanding of 

 impaction of the small intestines. I feel quite certain 

 that the better understanding of both of these conditions 

 is now only a matter of a short time. 



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