When  the  displacement  arises  from  narrowing  of  the  thorax
and  the  creation  of  a  low  and  long  waist,  the  hepatic  and  splenic
flexures  of  the  colon  are  forced  inward  and  backward,  and
the  transverse  portion  of  the  bowel  is  not  infrequently  bent
into  the  form  of  a  V  with  the  apex  pointing  toward  and
reaching  within  a  few  inches  of  the  pubes.  These  changes
in  the  position  of  the  colon  are  productive  of  muscular  in-
sufficiency and  encourage  stagnation  and  fermentation  of
its  contents,  which  in  their  turn  may  lead  to  chronic  colitis.
Physical  Signs. — Artificial  inflation  of  the  stomach  shows
that  the  fundus  reaches  an  abnormally  high  level  in  the  chest
and  causes  displacement  of  the  apex  of  the  heart  to  the  right.
Splashing  sounds  are  obtained  with  difficulty,  and  the  great


TREATMENT.  245

curvature  may  lie  so  much  above  its  usual  position  as  to  give

the  impression  that  the  stomach  is  unduly  small.
