500 



HERNIiE. 



or with some iinirritating disinfectant, to guard against peritonitis, 

 and are then reduced. 



The abdominal wound must afterwards be carefully sutured. This 

 is performed in two stages. The musculo-serous layer is first brought 

 together with catgut, or better still with silk, and the skin joined by 

 means of deep and closely-placed stitches. To prevent these sutures 

 being torn out, and to support them, the abdomen is swathed in a 

 broad cloth bandage, tightly applied. 



FISTULA OF THE DIGESTIVE APPARATUS. 



Fistulas of the digestive apparatus are of accidental origin and of 

 relatively small practical interest. In most cases they necessitate 

 surgical and other treatment of too delicate a kind and too prolonged 



Fig. 225. — Fistula of the rumen. 



a character to Justify the necessary expense. Their nature and origin 

 sufficiently suggest the course to be adopted. 



These fistulfe are divisible into two varieties, gastric fistulge and 

 intestinal fistulse. Gastric fistulae comprise fistulae of the rumen, reti- 

 culum, and abomasum. They may be of external origin, but in the 

 majority of cases they are produced by foreign objects accidentally 

 swallowed and eliminated through the medium of an abscess of the 

 abdominal walls. Their position and direction indicate their point of 

 origin. (Fistulfe of the rumen appear on the left side of the reticulum, 

 near the ensiform cartilage and middle line ; those of the abomasum 

 on the right side, near the middle line.) In doubtful cases, chemical 



