OBSTRUCTION OF THE BOWELS. 
109 
different methods of rearing, the one may altogether feed 
cattle, while his successor may both winter and feed some. 
There might be a deal said on the advantages the byre pos- 
sesses over the straw-yard for feeding cattle; while, on the 
other hand, the straw-yard might, in certain circumstances, 
present others over the byre, were each of their defects and 
properties thoroughly explained.”— The Farmers’ Herald , Dec., 
1852. 
ON OBSTRUCTION OF THE BOWELS. 
Mr. Phillips has delivered, at the Westminster Hospital, 
a clinical lecture on this subject. After making a variety of 
desultory observations relating to the causes, seat, and 
symptoms of obstruction, Mr. Phillips closes with these 
practical suggestions : 
u When we are called upon to treat a case of obstruction 
of the bowels, we should first carefully examine externally 
the whole of those regions in which a protrusion of the ab- 
dominal viscera may take place. 
“Supposing a tumour to be found, our difficulties may 
not be mastered, because there still remains the important 
question — Is that tumour the cause of obstruction ? It is a 
question which has been often asked. It has often been 
answered in the affirmative ; its contents have been exposed 
by operation, and in many instances it has been found to 
have nothing to do with the obstruction. Still, in the ab- 
sence of any other apparent cause of the obstruction, we are 
justified in such a case in performing an exploratory 
operation. 
“ Supposing no such tumour to be found externally, we 
then examine carefully the state of the abdominal cavity. 
If a tumour be discovered within, it is often very difficult to 
determine what it is, and what connection it has with the 
obstruction. Is it intussusception? Is it, as in Reybard’s 
case, a carcinomatous tumour of the intestine itself? Is it an 
omental tumour pressing upon the canal, as in three cases 
that have happened within my own experience? Is it a 
foreign body within the canal, such as a biliary calculus, an 
intestinal-concretion, a hair ball, hardened faeces, a collection 
of fruit stones ? These are questions of great importance, 
but of very difficult decision. 
“ If we are unable, by an ordinary examination, to detect 
a tumour or fulness,’ our investigation must be carried 
xxvi. 15 
