Treatment. 



305 



tarrli or intestinal meteorism. As a rule only one evacuation 

 of the stomach is necessary, but occasionally the operation 

 must be repeated. 



Evacuation of the gastric contents by the stomach catheter. The latter 

 consists of a tube 2.25 meter long, 27 mm. in diameter of ordinary red rubber 

 or of the more economical "durit"; its inner diameter is 16 mm. The tube is 

 armed with a flexible rod (cane) of the proper strength and the rod is provided 

 with a conical button at its distal end. (Fig. 36.) This stomach catheter con- 

 structed by Marek has the advantage 

 over Monroe's ordinary stomach tube, 

 that it is less easily damaged by the 

 teeth, and that it will remain in good 

 condition for years if protected against 

 the action of fats; however it becomes 

 longer and somewhat thicker if used 

 frequently. 



The introduction of this catheter is 

 possible without difficulty in almost 

 every horse with the proper assistance 

 (at least 3 to 4 assistants are neces- 

 sary) ; with the animal standing up, 

 the introduction is frequently as easy 

 as in cattle. Two or if necessary more 

 assistants draw the head of the animal 

 down and introduce a Bayer mouth- 

 speculum between its molars or they in- 

 troduce a mouth gag wrapped in cot- 

 ton, oakum, etc. The assistant who 

 holds this instrument elevates the lower 

 portion of the head in a manner to 

 bring it in a line with the neck. The 

 tongue is now drawn laterally out of 

 the mouth, the catheter end to ])e in- 

 troduced is made slippery with oil, 

 fat, vaselin or best with glycerine, and 

 is now carefully, but rapidly intro- 

 duced with both hands along the hard 

 palate into the pharynx and pushed 

 along until the introduced portion is 

 equal to the previously measured dis- 

 tance between the cardiac end of the 

 stomach and the incisors. After the in- 

 troduction of the catheter rattling gen- 

 erally occurs, but this is of no signifi- 

 cance. If the catheter meets any re- 

 sistance before getting into the 

 stomach, this may be overcome by with- 

 drawing the instrument several times 

 and then pushing it along again or 

 by removing the rod and pouring 1-2 

 quarts of lukewarm water into the 

 tube; this brings about a relaxation 

 of the esophageal wall and of the 

 cardia. After the rod has been with- 

 drawn the tube should be well intro- 

 duced into the stomach, otherwise the 

 procedure may not be successful. (The Fig. 37. Introduction of the stomach cathe- 

 length of the introduced tube should ter into the horse 



be 116-125% of the height of the ani- 

 mal as ascertained by a tape measure.) 



If there is no evacuation of the stomach after removal of the rod, this may be 

 brought about by closing the outer end of the tube during inspiration and opening 

 it during expiTation; in this manner, we make use of the suction produced by 

 the negative intrathoracic pressure. In other cases the desired end may be 

 obtained by pulling forward and backward on the free end of the tube or by 

 allowing 2-4 quarts of water to run into the tube, while the head of the horse and 



Vol. 2—20. 



