GESTION

Intestinal Obstruction may be acute; caused by strangulation by bands or adhesions, by volvulus or rotation of the intestine on its own axis so as to produce strangulation, by acute intu usception or the telescoping of one portion of the intestine into the part below, by the termination of chronic obstruction, by kinking or through peritonitis; or the obstruction may be chronic, due to impaction of feces or foreign bodies, to stricture, tumors, and other affections of the intestinal wall, or to comp res sien of the intestine from tumors or adhes-. ions without. The symptoms of the former are sudden severe pain, later becom-’ ing continuous, in the region of the umbilicus, shock and collapse. There is persistent vomiting, which soon becomes very offensive, the bowels do not move, the abdomen becomes distended, and peritonitis’ comes on if the obstruction is not relieved by immediate operation. In regard to chronic obstruction, there are colicky pains, with constipation alternating with diarrhoea, and finally acute obstruction takes place. The treatment before the case becomes acute is a fluid diet, enemata, and small doses of cascara or calomel, Operative treatment is generally carried out at an early stage. H (1/4) h (1/4)