1. Excessive accumulation of gas is very frequently caused by an increase in the secretion on the internal surface of the intestine, accompanied by an impediment to its escape. This occurs over a large extent of intestine in morbid affections of the mucous membrane, and especially in the exudative processes, such as typhus, in the shape of tympanitis; the escape of the gas is impeded by the paralyzed state of the muscular coat. This condition also accompanies anomalous states of other intestinal secretions, especially of the intestinal mucus, or morbid affections of the nervous, especially the ganglionic, system; in the latter instance, however, there is frequently no increase in the amount of gas secreted, but in consequence of the atony of one portion of intestine, and spasmodic contraction of the remainder, or of atony of the entire tube, it accumulates, and is retained in the shape of tympanitis throughout the canal.

Occasionally, an excessive accumulation of gas is brought on by the consumption of certain flatulent articles of diet in a debilitated state of digestion, or where there is an absence of the due amount of bile.

2. The intestinal mucus is very often found in excess, and occasionally the amount secreted is insufficient: in the former case, it also undergoes considerable modifications as to quality. The increase of secretion either exists throughout the intestinal canal, or affects certain sections in the shape of chronic catarrh or blennorrhoea; the mucus is either milky, white, yellowish and purulent, or glutinous, transparent, vitreous, spawny. In the congestive state of typhous and typhoid diseases, we find a peculiar gelatinous mucus on the intestinal mucous membrane, and more especially on that of the small intestine and caecum.

A diminution in the quantity of mucus accompanies excessive formation of bile and of feculent matter (copropoesis).

3. There can be no dou't that a peculiar gelatinous constitution of the mucus is the nidus of intestinal entozoa, and the cause of helminthiasis. There are two orders of worms, the nematoidea and the ces-toidea: to the former belong the ascaris lumbricoides, the trichocephalus dispar, and the oxyuris vermicularis; to the latter, the taenia solium and the botryocephalus dispar.

The lumbricus occurs in the small intestine of children and young persons, and is sometimes found in large numbers, forming knotted accumulations. It often ascends to the stomach, into the oesophagus and pharynx, it may even pass from here into the larynx, and thus, as has been distinctly observed, produce suffocation. Occasionally, several lum-brici may be found undertaking such and similar preposterous peregrinations at the same time.

The trichocephalus dispar inhabits the caecum and the adjoining portion of the small intestine. Its occurrence in the gelatinous, feculent contents of these parts in typhus, is very important.

The oxjuris (ascaris) vermicularis inhabits the rectum.

The taenia is found, one or more in number, in the small intestine.

We may still be permitted to doubt the fact that the entozoa ever perforate the intestine, at all events, it is a very rare occurrence. It is well established, however, nor is it of very unusual occurrence, and this applies especially to the lumbricus, that they pass through orifices in the intestinal parietes into the abdominal cavity, into abscesses, into the bladder or the vagina.

4. The faecal matters offer various important points for consideration. They sometimes accumulate in the intestine to an extraordinary degree, in consequence of repletion, torpor of the intestine, diminution of the intestinal secretion, increase of the absorbent powers of the intestine, and induration of the faeces. These accumulations occasionally affect single portions of the intestine, and may, if persistent, induce disease of the coats.

The occurrence of an excessive elimination of faeces (copropoesis exce-dens) from the intestinal secretions, is an established fact. It takes place as a critical discharge in various diseases, and especially in those that are accompanied by increased secretion in the intestinal canal; but recent observations have demonstrated its occurrence as an idiopathic disease, which may, by the excessive drain it causes, give rise to atrophy of the intestinal coats and to general emaciation. The color of the faeces mainly depends upon the color and degree of saturation of the bile. They may be dark-brown, dark-green, black, pitchy, or, in the absence of bile, grayish or clayey. Occasionally the faecal discharge is brown internally, and invested by a white clayey covering, of varying thickness.

The consistency of the faeces varies considerably: they are liquid when the serous exhalation of the mucous membrane is excessive; semifluid when the secretion is muco-gelatinous; or they are mixed, with the secretion in the shape of flocculent grumous particles. The feculent matter found above the various intestinal strictures presents a peculiar frothy appearance.

The faeces may have hardened, so as to present lumps or scybala of various sizes. This scybalous induration generally takes place in the sigmoid flexure and the rectum, though it occasionally reaches up to the caecal valve. If accompanied by flatulency, small portions of feculent matter are found to adhere to the intestine, and after the mucus by which they were made to adhere has dried up, they appear agglutinated to, and even imbedded in, the internal surface of the intestine.

Figured faeces either form cylinders, which may be variously affected by pressure of the intestine or by stricture, or they form tubers of various size. This leads us to a consideration of faecal concretions and intestinal calculus.

5. Intestinal concretions are either formed in the intestine, or after being formed external to it, reach it by the natural or by abnormal passages.

To the former belong indurated scybala, which may be produced under all the circumstances that give rise to a retention of faeces; and especially the tuberculated faecal concretions that form in and adhere to the cavity of colonic diverticula. They may be various foreign bodies, such as fruit-stones, indigestible portions of vegetables or pieces of bone, which have been introduced into the intestine, and become incrusted with faecal matter. Or such bodies, especially when occupying a blennorrhoic portion of intestine, as the vermicular process or caecum, give rise to deposits of grayish fatty matters, chalky and saline substances.