TREATMENT OF TWIST OF THE COLON. 
333 
was strongly adducted, its volar surface or the fingers were laid against 
the bands, and after repeated careful attempts finally succeeded in 
drawing these so far towards the right that the colon again took up its 
position parallel with the middle line of the body. As had been shown 
by the experiments on dead animals, in torsion towards the left, the 
bands of the lower section of the bowel offer a purchase for retroversion. 
After effecting this, the pelvic flexure of the bowel, until then filled with 
gas, at once collapsed, the symptoms of colic disappeared, peristaltic 
action, which had almost completely ceased, again set in, the small, 
frequent pulse altered its character, and half an hour later the lecoveiy 
of the animal could be confidently foretold. 
It is clear that all torsions of the colon cannot he treated by one and 
the same method; differences in displacement will render modification 
necessary ; but when attention has been directed to the point, expeiience 
will give valuable indications for procedure. Puncture of the over¬ 
distended colon might possibly assist reduction (see Puncture of the 
Bowel ”). Jelkmann was compelled to puncture the caecum five times m 
thirteen cases, after which retroversion succeeded ; the use of the tiochai 
caused no bad results. 
Before attempting manipulation, Gultmann evacuates the gas by 
puncture. Imminger and others recommend puncture, and claim to 
have seen reduction of the twist in consequence. Whether puncture is 
always necessary can only be settled by more extended obsei\ation. It 
is desirable that reduction should be attempted oftener than at present; 
those who have tried it speak of the method in favourable terms. 
Moller describes the following case: 
On June 8th, 1890, I was called to see a heavy cart-horse which had been 
suffering from colic for twenty hours. There was moderate but continued 
restlessness; the animal lay down frequently, but soon rose again, moved 
about in various directions, and showed all the symptoms of obstruction o 
the bowel. The pulse was sixty-five per minute, small and weak, the mucous 
membranes dirty red, respirations thirty and shallow, the flank moderately 
distended with gas, peristalsis occasionally slightly audible at the light sice, 
general perspiration. Defalcation had been in abeyance for twenty hours 
only three hard portions of dung having been passed the appetite had 
decreased during the same period, and drink was only taken m small 
quantities. Examination per anum discovered the pelvic flexure of the colon 
greatly distended with gas, which caused it to be pressed towards the posterior 
wall of the pelvis. On the outer surface of the colon a tense coid could be 
felt which passed from above downwards and inwards, from behind upwards 
and outwards. A similar cord passing in the same direction could be 
detected on the inner surface of the colon; the urinary bladder was on y 
^ The hand introduced into the rectum, was laid in the above described 
manner against the outer cord, and after several attempts it was found possible, 
by very considerable exertion, to move the bands of the colon towards t re 
middle line of the abdomen. Active peristalsis and passage of gas at once 
