309 



DISEASES OF THE LIVER. 



As veterinary practice has improved, much light has been thrown on the 

 diseases of the liver not perhaps on the more advanced and fatal stages ; but 

 giving us the promise that, in process of time, they may be detected at an 

 earlier period, and in a more manageable state. 



of the muscles, an incision was carefully made 

 through the integument into the sac, in a line 

 with the inferior border of the cartilages of the 

 false ribs, which incision was about seven 

 inches in length. This, as we had hoped, 

 proved to be directly upon the aperture in the 

 muscular parietes of the abdomen. The in- 

 testines were exposed ; and, after having suf- 

 ficiently dilated the opening to permit the in- 

 troduction of the hand, they were quickly re- 

 turned, portion after portion, into their proper 

 cavity, together with a part of the omentum, 

 which we found somewhat annoying, it being 

 frequently forced back again through the lace- 

 ration. 



" At times, it required the exertion of our 

 united strength to prevent the escape of the 

 intestines, and which was only effected by 

 placing our hands side by side, covering and 

 pressing upon the opening. By these means 

 we succeeded in keeping in the viscera, until 

 we were satisfied that we had placed them all 

 within their proper cavity. At about the 

 central part of the aperture, we decidedly 

 found the greatest pressure of the intestines to 

 effect an escape. 



" A strong metallic suture of flexible wire 

 was then passed through the edges of the 

 laceration, taking in the peritoneum and por- 

 tions of the transversalis, rectus, and internal 

 abdominal muscles ; and other sutures, em- 

 bracing the same parts, were placed at con- 

 venient distances, so as nearly to close the 

 aperture. Two sutures of smaller metallic 

 wire, and three of stout silk cord, were then 

 passed through the external abdominal muscles, 

 and their aponeuroses, which effectually shut 

 up the opening into the abdomen. The inte- 

 gument was then brought together by the in- 

 terrupted suture, taking care to bring out the 

 ends of the other sutures, and which had been 

 purposely left long, so that in case of super- 

 vening inflammation, or swelling, they might 

 be readily examined. The whole operation 

 occupied rather less than an hour, our poor 

 patient being occasionally refreshed with some 

 warm gruel. 



" The hobbles were now quietly removed, 

 and, after lying a few minutes, she got up, 

 and was placed in a large loose box. A com- 

 press and a suspensory bandage, that could bo 

 tightened at pleasure, were applied to the 

 wound. The pulse was now 84. She was 

 ordered to be watched, and to have some tepid 

 water placed within her reach, but on no ac- 

 count to be disturbed. 



" At 10, P.M., the pulse had sunk to 06. 



The respiration, which had been much accele- 

 rated, was quieter. She was resting the leg on 

 the side operated upon, but did not appear to 

 be suffering any great pain. Some faeces had 

 passed, and she had taken a small quantity of 

 bran mash. The parts were well fomented 

 with tepid water, an oleaginous draught was 

 administered, and likewise an enema. 



*' 25th The pulse is a little quickened ; the 

 sac which had contained the protruded intes- 

 tine was filled with a serous effusion. I made 

 a dependent orifice in it, and from three to 

 four pints of fluid escaped. This much re- 

 lieved her, and she continued to go on favour- 

 ably throughout the day. 



" 26th. Suppuration now began to be esta- 

 blished, and the parts were dressed with the 

 compound tincture of myrrh. 



" 30th. She was enabled to take a little 

 walking exercise j and on this day some of the 

 integumental sutures came away. 



" Nov. 4th. The sloughing process being 

 now set up, three of the smaller metallic 

 sutures, that had been used to bring the edges 

 of the laceration together in the external ab- 

 dominal muscles, came away. The parts were 

 minutely examined, and we detected a sinus 

 running towards the mammae, and filled with 

 pus. With some little difficulty it wag 

 opened, and a tape passed through it, so as to 

 allow the pus to escape as quickly as it was 

 formed. The appetite was tolerably good, 

 and the pulse ranged from 52 to 56.. 



" 6th. The patient was so far recovered 

 that I ventured to turn her into one of the 

 paddocks for a few hours' exercise, taking 

 care to avoid any exposure to cold, if the 

 weather was stormy. 



" llth. An incident occurred which nearly 

 brought our hitherto successful case to a fatal 

 termination. I saw her safe about 1, P.M. ; 

 but at two o'clock a messenger came in haste 

 to apprise me that she was in a pond at the 

 bottom of the paddock, and fixed in the mud. 

 There, indeed, I found her, at a considerable 

 distance from the bank, and making the most 

 violent efforts to release herself. With con- 

 siderable difficulty, and after many unsuccess- 

 ful attempts, we succeeded in dragging her 

 ashore, so much exhausted as to be utterly in- 

 capable of rising. A gate was procured, and 

 being well covered with straw, she was drawn 

 homeward by two horses ; I following, re- 

 gretting what had occurred, and not a little 

 blaming myself for having exposed her to 

 this misfortune. 



" Having placed her in her box, our first 



