A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . be somewhat re-lieved by external pressure. In stricture ofthe intestines pain is said to be more inter-mittent in character ; while in volvulus it ismore diffused than localized. Collapse andactual syncope is marked in many cases ofintestinal obstruction, while vomiting, firstof the contents of the stomach and subse-quently of bile, is usually present. Consti-pation, tenderness, swelling, and distentionof the abdomen are marked
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . be somewhat re-lieved by external pressure. In stricture ofthe intestines pain is said to be more inter-mittent in character ; while in volvulus it ismore diffused than localized. Collapse andactual syncope is marked in many cases ofintestinal obstruction, while vomiting, firstof the contents of the stomach and subse-quently of bile, is usually present. Consti-pation, tenderness, swelling, and distentionof the abdomen are marked symptoms. Therolling of the distended intestines over each other from interferencewith normal peristaltic action causes at times marked gurgling. Ifthe abdomen is thin, the hands placed upon its surface may feel themotion of the intestines and at times even locate the seat of the ob-struction. Exhaustion, peritonitis and gangrene are the usual causesof death. In acute intestinal obstruction death occurs in from one toseven days. In intussusception the portion of the gut which is pushedinto the adjoining part of the intestine may slough off, because of the Fig. T E Intussusception (diagrammatic) :/, single intussusception; II, doubleintussusception : a, the upper inva-ginated portion ; b, the lower por-tion of the bowel. (Tillmanns.) 634 DISEASES OF THE ABDOMEN AND PELVIS. constriction made upon it by the sheath which grasps it, and be dis-charged from the anus. The continuity of the caliber of the intestinemay be reestablished in this way, because, during the stage precedingsloughing, the walls while in contact have become united by inflam-matory adhesions. In chronic obstruction of the bowels pain and vomiting are oftennot very marked, but obstinate constipation is a prominent does not occur early in such cases, but when it occurs itis marked. Spontaneous recovery sometimes takes place, while death,which is a common result, does not occur until after six or ei
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