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When there are no solid indigesta, but a fluid composed principally of vitiated bile or extravasated blood, there will be a strong indication of the presence of rabies. When, also, there are in the duodenum and jejunum small portions of indigesta, the detection of the least quantity will be decisive.
This man had 18 wounds, 14 having penetrated the abdomen, the liver, colon, and the jejunum being injured; by frequent bleeding, strict regimen, dressing, etc., he recovered his health and senses, but relapsing a year and a half later, he again attempted suicide, which gave the opportunity for a postmortem to learn the extent of the original injuries.
Into this portion opens the bile duct from the liver with the duct from the pancreas, these having been first united and then entering the intestine as a common duct. The next portion of the intestine is called the jejunum, because it is usually empty after death. The remaining portion is named the ileum, because of the many folds into which it is thrown.
The remaining part of the small intestine is so long that it has to coil itself in many folds in order to find room in the narrow space of the abdominal cavity. It is divided into the jejunum above and the ileum below. In the last section of it is the part of the small intestine at which in the embryo the yelk-sac opens into the gut.
The first eight or ten inches form a short curve, known as the duodenum. The upper two fifths of the remainder is called the jejunum, and the lower three fifths is known as the ileum. This is known as the ileo-cæcal valve. The mucous membrane of the small intestine is richly supplied with blood vessels and contains glands that secrete a digestive fluid known as the intestinal juice.
The next of the small intestines is the 'jejunum', so called from its being generally empty. It is smaller in bulk than the duodenum, and the chyme passes rapidly through it. Next in the list is the 'ileum'; but it is difficult to say where the jejunum terminates and the ileum commences, except that the latter is usually one-fifth longer than the former.
Fillion mentions an instance of recovery following the perforation of the jejunum by a piece of horn which had been swallowed. Madden tells of a person, dying of intestinal obstruction, in whose intestines were found several ounces of crude mercury and a plum-stone. The mercury had evidently been taken for purgative effect.
Death was caused by a well-defined round perforation at the cardiac curvature the size of a sixpence. Anomalies of the Intestines. The Ephemerides contains the account of an example of double cecum, and Alexander speaks of a double colon, and there are other cases of duplication of the bowel recorded. There is an instance of coalition of the jejunum with the liver, and Treuner parallels this case.
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