TORSION OF THE DOUBLE COLON 27 



linger on for from four to six hours, sometimes, perhaps, 

 for even eight. Seldom, however, is it longer than that. 

 The case just rapidly runs its course, until, after a short 

 period of apparent ease just prior to death, the animal 

 drops and dies in convulsions. The period of apparent 

 ease is, of course, due to the animal standing quiet, and 

 to all appearances free from trouble, when, owing to 

 extensive gangrene of the twisted bowel, all sensation 

 therein is dead. 



Diagnosis. — It is not the condition of complete twist, 

 but that of incomplete, which will call for the veterin- 

 arian's skill in diagnosis. I shall, therefore, consider that 

 first. At the outset I would say that a close study of 

 the symptoms will enable the veterinarian to diagnose 

 these cases with comparative accuracy. It is worth 

 noting, however, that diagnosis of the condition in its 

 quite early stages is by no means easy. Indeed, it is very 

 often difficult. At the very commencement, therefore, 

 it is well to admit to ourselves what these difficulties are. 



In the main the difficulties encountered in forming our 

 diagnosis lie in the fact that the plainly fatal symptoms 

 are developed only gradually. On a first visit, unless 

 the observer is particularly alive to the significance of 

 quite little things, nothing grave may be noted. The 

 colon, twisted to the extent of causing venous strangu- 

 lation only, does not cause pain sufficiently severe to 

 alarm. The fact that early in the case the pulse is full 

 and bounding, as in an ordinary case of impaction, 

 becoming weak and compressible only with the progress 

 of the case, is not a circumstance conducive to the 

 making of a correct diagnosis at an early stage. 

 The irritable passing of the faeces may be read for 

 normal evacuations, while the manner in which the 

 patient stands, apparently quiet and free from pain (the 



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