TORSION OF THE DOUBLE COLON 281 



evidence that gangrene has commenced — a fact we were 

 previously inclined to acknowledge to ourselves on 

 account of the, odour of the escaping gas, an odour 

 which perhaps can best be described as ' putrid.' 



With these last two grave symptoms to weight the 

 balance — namely, the deathly pallor of the visible mucous 

 membranes, and the gradually increasing tympany (a 

 tympany which the use of the trocar relieves only tem- 

 porarily) the veterinarian no longer merely suspects 

 twist. His suspicions have become certainties, and his 

 diagnosis is complete. In fact, he may now communicate 

 his opinion to the owner in language no longer tentative, 

 and with a tolerable certainty of being able to demonstrate 

 the torsion at the autopsy. 



In the case of complete twist diagnosis is not nearly so 

 difficult to arrive at. The grave nature of the case is 

 only too apparent at the very outset. The rapidity with 

 which the symptoms are developed ; the intensely 

 agonizing character of the pains at the very commence- 

 ment ; and the full bounding pulse and highly injected 

 mucous membranes, are all sufficiently alarming and 

 indicative. Evidently the case is one of torsion of some 

 portion of the bowel. Even then it may be summed up 

 to the owner in the one word ' twist.' 



In addition to this, the veterinarian notes the persistence 

 of the high colour of the mucous membranes — no ten- 

 dency at all to pallor, but on the contrary a continuation 

 of as high a state of engorgement of the vessels as it is 

 possible to get. He makes the mental note ' complete 

 strangulation. ' Complete strangulation necessarily means 

 complete torsion, and his diagnosis is arrived at. Rapid, 

 one would think, and liable to error. But, if they are 

 wanted, there are still other indications — namely, the pro- 

 fuse baths of perspiration, the muscular tremors, the 



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