668 
CASE OF VOLVULUS ILEI. 
and this could not now be done without first snipping the mesen- 
tery in places to relieve the confined portions of gut. What was, 
however, extraordinary in this case, and what I never before wit- 
nessed, was a lusus natures, in the shape of an appendix or pouch, 
in the strangulated portion of the ileum, and which had, no doubt, 
much to do with causing the strangulation : at all events, the 
appearance of the malformation at that part of the intestine which 
was involved in the offending parts, would lead one to conclude 
that it had been instrumental in producing it. The strangulated 
portions of the intestine were of a dark modena red colour, from 
intense inflammation ; but mortification had not taken place. The 
stomach was distended to twice its usual bulk, and, with the intes- 
tines above the knot, was as full as the canal was empty below it. 
The latter had clots of coagulated blood on their internal surface. 
In 1829 I communicated a very similar case through the pages 
of your Journal, and which occurred in a favourite horse of George 
IV. The strangulation, however, in that case was caused by an 
“ appendicula epiploica” having formed a knot in the ileum, which 
could not be undone, even after death. The king expressed such 
a wish to see the parts after death, that, they being too stinking — 
in the month of May — for His Majesty’s chamber, I had the parts 
cast in wax ; and they were coloured so true to nature, that His 
Majesty was exceedingly pleased, and, like many others, could 
not but imagine “ they smelt,” so perfect was Mr. Miller’s artificial 
representation. 
The annexed cut will shew the unnatural formation of the por- 
tion of strangulated ileum. 
A to B the normal canal of the ileum. C the blind appendix, which mea- 
sures seven inches in length, and is, if any thing, larger in its caliber than the 
other portions of the intestine. 
