GASTRIC DISTURBANCE DUE TO FOREIGN BODIES. 201 



knows what he is trying to find. Without this information he acts in the 

 dark, is obhged to abandon himself to chance, and although luck some- 

 times favours him, it more often leaves him in the lurch. 



(3.) Foreign bodies pointed at both ends. Bodies like needles, pins, 

 straight fragments of iron wire, knitting-needles and broken hairpins, 

 become implanted in the gastric walls and travel in the most diverse 

 directions, in obedience to the varied movements of the organ injured. 

 They produce results similar to those just described. Most frequently 

 they fall into the lower part of the gastric compartments, pass near the 

 ensiform cartilage, between the pleura and the triangularis sterni into 

 the thickness of this muscle, or into the mediastinum, and there produce 

 either an abscess in the region of the ensiform cartilage, an abscess of 

 the thoracic wall, or a collection of pus in the sub-pericardial or sub- 

 pleural region (pseudo-pericarditis). They may even reach the peri- 

 cardium, causing pericarditis, and sometimes, when adhesions are set up 

 between the heart and pericardial sac, carditis. 



By deviating to the right or left, the foreign body may produce 

 pleurisy or even pneumonia. If it moves towards the right, it involves 

 the liver and produces suppurative hepatitis ; if to the left, suppurative 

 splenitis. Travelling in a downward direction, it encounters the abdo- 

 minal wall, and after producing an abscess may be eliminated ; passing 

 backwards, it falls into the peritoneum, and may lead to peritonitis. In 

 those exceptional cases in which foreign bodies reach the abomasum 

 they generally become implanted towards the greater curvature, pro- 

 ducing in the abdominal wall an abscess which breaks externally, and 

 through which the foreign body is discharged ; gastric fistula is then 

 a common sequel. 



The symptoms vary, according to the complications. The earliest 

 comprise digestive disturbance, which coincides with the passage of the 

 sharp object through the rumen or reticulum, and depends on whether 

 such passage produces local peritonitis and pain, rendering movement of 

 these compartments impossible. Later, when the diaphragm has been 

 penetrated, respiratory disturbance occurs, and is" succeeded by apparent 

 improvement, which in its turn may be followed by the occurrence of 

 pericarditis, pleurisy, or abscess formation. 



In other cases where suppurative hepatitis or splenitis, or even 

 peritonitis may be present, the symptoms are extremely vague and very 

 difficult to refer to their real cause. 



Diagnosis is difficult, unless the owner is able to supply exact infor- 

 mation that at some previous time the animal had swallowed such and 

 such an object. 



The prognosis is grave, though cases occur where a foreign body is 

 tolerated, and may for a long time be retained without producing accidents. 



