POSSIBILITY OF SPONTANEOUS REDUCTION 319 



and that, once in its normal position again, resolution of 

 the commencing morbid changes in its walls is rapidly 

 brought about. 



I, for one, believe this. In many cases that I can 

 call to mind I have been absolutely certain, if the know- 

 ledge I have gained in this particular line is of any use 

 at all, that I have been dealing with a case of intestinal 

 displacement. And in just as many of these cases I have 

 been quite convinced that nothing but a fatal termination 

 could ensue. Much to my astonishment and gratifica- 

 tion, some of these cases, usually under the action of a 

 dose of eserine, have taken a sudden change towards 

 recovery. One can, in fact, almost stand by and watch 

 the change occur, knowing, so far as we can know in 

 these cases, that we have seen a case of twist respond 

 to treatment. 



But I would rather not leave this contention unsup- 

 ported. Sooner than do that I will give here the 

 remarks of the late Professor Walley. In connection 

 with the use of the trocar and cannula in these cases he 

 says : 



' In cases of twist or displacement where the tym- 

 panitic intestine can only be felt through the wall of 

 the rectum, there should be no hesitation in introducing 

 the cannula through this gut. The use of the cannula 

 in the circumscribed tympany accompanying torsion and 

 displacement is a point to which I wish particularly to 

 draw your attention. I am satisfied that some cases of 

 partial twist and displacement are cured by the spon- 

 taneous reduction of the involved knuckle of intestine, 

 and that not infrequently the gradual removal of the 

 imprisoned gas by absorption or otherwise is an im- 

 portant factor in this reduction.' 



Once we recognize the possibility of reduction in these 



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