54 
J. MYERS, Jr. 
abdominal walls, which seem to be engorged with blood in consequence 
of stagnation, brought on by the pressure of gas, and is of minor 
importance. 
The evidence of relief, if not entire convalescence, is markedlv 
manifested, the previous restlessness is transformed to a state of quiet¬ 
ude, collapse of the abdominal walls is very obvious, the previous 
anxious expression assumes a grateful countenance, the injected cynotic 
visible mucous membranes become florid, the laborious respiration 
calm, the reoxigination of blood returns followed by the strengthened 
condition of the heart, reproducing an equalization of temperature, 
oscultation reveals the return of borborygmus, also does the bladder 
resume the power to evacuate its contents, and if coma has supervened 
“the result of pressure upon the vascular system,” with the cessation of 
all other perilous symptoms it certainly must subside. 
Enterotomy may also be employed as a palliative measure with 
benefit. There are diseased conditions of the abdomen such as 
Peritonitis, Constipation, Emboli, Thrombi, Strangulated Hernia, 
Calculi, etc., where flatulency is present as a secondary effect and is 
merely symptomatic, nevertheless often exerts suflicent destructive 
influences over the vital organism to produce death, before the morbid 
condition of the bowels can be eradicated, hence the use of the trocar 
is indicated, thereby relieving pain and enabling the original disease to 
ameliorate or run its course, also would it insure more time for the 
action of medicines and allow the circulatory system to proceed bv 
virtue of the relieved tension, causing dilatation of the bloodvessels and 
return of nervous force promoting increased peristaltic action of the 
bowels which enables the gasses and foecal matter to find an exit; all 
of which are valuable factors in the restoration of life ascribable to the 
operation. 
On inspecting a case of flatulent colic while in a recumbent posture, 
it would seem to be the most proper moment to perform the operation, 
by reason of the increased distention of the visible side, which is a 
mistake; there are great dangers connected with this method, should 
the patient happen to struggle or make an attempt to rise, the sharp 
point of the stylet or retained canula is apt to injure the intestines, 
moreover the trocar is liable to break at the handle or somewhere 
through it smetallic course, which would be an unpleasant occurrence to 
both practitioner and patient. I have had frequent occasions to put this 
method of treatment into practice from the fact that the consummation 
n 
