166 



DISEASES OF THE DIGESTIVE APPARATUS. 



Tereg^ asserts that the production of phenol is rather hindered 

 than increased. 



In most cases death happens through septic infection, through 

 pulmonary œdema, or through carbonic acid intoxication. 



Symptoms and course. The course of thrombo-embolic colic 

 is far from being uniform. We may recognize the following modi- 

 fications : 



1. Acute course ending in recovery. The colics belonging to the 

 first group come and go without any definite exterior cause ; they 

 have much similarity with colics of a rheumatic nature, for they 

 are extremely painful. Their duration is short. They are probably 

 due to partial emboli of the intestinal arteries (from a colic or 

 csecal artery). They disappear gradually as soon as the circulation 

 is re-established through the auastomoses. As it is very difficult 

 to make the differential diagnosis, these colics are often confounded 

 with other affections of the intestine. Sometimes, however, the 

 reaction of the urine may guide us : in acute embolic colics it is 

 alkaline, in colics due to enteritis it is acid. They are not due to 

 the action of cold ; this fact enables us, in some instances, to dis- 

 tinguish it from nervous colics. 



2. Acute course with fatal end. To this group belong all emboli 

 producing changes in the relations and situation of the intestine. 

 The colics thus provoked appear without appreciable external cause. 

 The pains are sometimes insignificant, contrary to what we observe 

 in most of these affections (Lustig). This fact is explained by the 

 sudden paralysis of the anemic intestinal compartment. Usually 

 the symptoms are similar to those of constipation colics produced 

 by changed relations of the abdominal organs. They have nothing 

 characteristic. Death occurs through tearing of the stomach or 

 intestine or through septic infection. 



3. Chronic course with a relatively favorable termination. Chronio 

 embolic intestinal catarrh. Colics of this variety are produced 

 through collateral hyperemia consecutive to arterial obliteration. 

 This congestion may persist for quite a long time (as in blood -stasis 

 of the portal system of the liver) and occasion chronic intestinal 

 catarrh (embolic intestinal catarrh). 



The course of the disease is ordinarily as follows : When the 

 first attack is over, the temperature and the number of pulsations 



1 Tereg : Archiv f. Thierheilkde., 1881. 



