TORSION OF THE PELVIC FLEXURE 301 



From what has already been set out under the symp- 

 tomatology of incomplete twist in Chapter XIX., it will 

 have been noticed that much depends on the history of 

 the case. When with such a history as we have there 

 described we meet with symptoms of gravity — notably 

 the spasmodic contraction of the rectum during explora- 

 tion, the continuance and gradual increase in severity 

 of the pains, the irritable passing of small quantities of 

 loose faeces, the weak nervous pulse, the raised tempera- 

 ture, the patchy sweats, and the agonized expression of 

 countenance — then we may be tolerably certain that 

 twist has occurred. It is another matter to locate it. 

 Sometimes, however, it may be correctly referred to the 

 pelvic flexure after some such manner as this : 



In such a case as we are considering we may at once 

 put twist of the small intestine out of the reckoning by 

 saying that in these cases the pain, rapid in its oncome, 

 is so insistent and so agonizing, abdominal distension so 

 rapid and so marked, the sweats profuse to a degree of 

 becoming quite early in the case a perfect bath, and the 

 position of the patient when down so often dorsal, as to give to 

 the veterinarian in a few short hours a fair inkling of the 

 true nature of the attack. 



Similarly, with complete twist of the colon — which 

 cases of complete twist always occur farther forward in 

 the colic loop than the pelvic flexure — the rapid oncome 

 of the pain, the profuse sweats, the highly injected 

 mucous membranes, the early exhibition of the sardonic 

 grin or haggard expression, and the rapid posting on of 

 the case to its end, all are indications which leave no 

 room for doubt. 



We may therefore sum up as follows : Our case is not 

 twist of the small intestines — the symptoms are being 

 unrolled far too slowly. If only for the same reason, 



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