m 
ENTANGLEMENT AND RUPTURE OF THE INTESTINE*?. 
and contracted, but the distended body as before. I succeeded 
in forcing it from the pelvis into the abdomen, but it immediately 
returned, when I discontinued the pressure. I concluded it was 
a portion of the colon. I ordered him a laxative, to empty the 
bowels. At two o'clock the following morning he was found roll¬ 
ing and tumbling about the box \n dreadful agony, in which state 
he continued until five o'clock, without the slightest remission of 
pain, and died. 
Post-mortem examination .—Three hours after death I com¬ 
menced my examination of the body, by an incision carried from 
the posterior cartilage of the sternum, through the linea alba, to 
the pelvis. I had no sooner gained the abdominal cavity, than 
a solution of feces burst forth, and proclaimed a rupture of some 
part of the alimentary canal. I then made two more incisions, 
one on each side, from the umbilicus to the transverse processes 
of the lumbar vertebra, and threw back the abdominal parites, 
when I beheld such a scene of entangled intestines as I never 
before witnessed, nor could I have previously conceived it pos¬ 
sible. Unassisted by the aid of an artist to take the intestines 
as they appeared in sit a, I cannot enjoy the pleasure of convey¬ 
ing a just idea of the true appearances; but the best I am ca¬ 
pable of is as follows :—The apex of the caecum lay in the hypo¬ 
gastric region, and was the only intestine in a state of distention ; 
its contents little else but gas; its extreme end was thrust into 
the cavity of the pelvis, and proved to be the elastic body I had 
discovered during life. The rectum and the colon, in a flaccid 
state, lay to the left side, and consequently exposed a consider¬ 
able portion of the small intestines. At the first view, many of 
their convolutions were very much entangled by three distinct 
cords, about the thickness of the ring finger, formed by torn por¬ 
tions of the omentum, which .membrane was very much thick¬ 
ened, and had more the appearance of the mesentery than of 
omentum. I did not discover any strangulation of any part 
of the small intestines, although so much fettered by these 
cords. They were flaccid, and the contents of the stomach had 
readily passed into the caecum caput-coli. I now proceeded to 
look for the rupture through which the contents of the intestines 
had passed in to the abdominal cavity, and, in clearing away the 
feces from the base of the caecum, I discovered a strong dense 
ligature, about three fingers in thickness, including that intestine 
about two hands breadth from its base : this ligature was formed 
by the mesocolon, firm in texture, and of a dark colour. Be¬ 
tween this ligature and the caput coli, to the left side, was a 
rupture to the extent of two inches in diameter; that portion of 
caecum strangulated by the ligature was much inflamed. In- 
