Editorials and Medical Intelligence

1864 Boston Medical and Surgical Journal  
several times. Independently of the state of the atmosphere of late, this condition was perhaps remotely caused by a malformation and transposition of the large intestine, in consequence of which a free and thorough evacuation of the organ seldom if ever took place. * * * * The rectum ascended from the anus to the right iliac fossa, thence up through the right lumbar region to the under surface of the liver, touching the gall-bladder. Then it bent sharply downwards, and descended, in contact
more » ... nded, in contact and parallel with the ascending portion, to the right iliac fossa. The colon then crossed the lower part of the abdomen to the left iliac region, up through the left lumbar region, almost to the stomach, terminating in the coecum. * * * The portion discolored with bile, from its contact with the liver, is where the sudden and abrupt bend of the organ downwards took place. This sharp flexure must have proved a serious obstruction to the evacuation of the bowel. From this turn to the caput coli the bowel was very much distended with flatus, and contained more than a quart of soft faecal matter, of the consistency of thin mortar. The only other morbid change found was an injected and softened state of the mucous coat of the stomach." An incision being made in the back part of the rectum, near the anus, displayed a very great contraction of that organ just before its original termination in the vagina. In fact, following this contraction was a cul de sac which communicated with the vagina, about its middle, by a delicate valvular opening ; the artificial auus continued the intestine down to its natural external termination. It will be under-
doi:10.1056/nejm186410200711205 fatcat:eenkep3jobhfddd352iplagux4