Treatment. 571 



powder or infusion, diuretin (0.5-1.0 giii. every two hours), 

 agurin (1.0-2.0 gin. daily), tlieocin (0.6-1.2 gm. per fifty kilos 

 of body weight [Albrecht]). Purgatives are less to be recom- 

 mended on account of their less certain action and the debility 

 of the animal. Besides the neutral salts, calomel is the drug 

 principally employed. Small doses (0.3-0.4 gm. for dogs) are 

 given, and if necessary combined with jalapin. 



Provided that the condition of the heart and lungs permit 

 of its use, injections of pilocarpine produce more favorable re- 

 sults by stimulating diaphoresis and the secretion of large quan- 

 tities of saliva. The dose that may be employed for dogs is 

 0.005-0.1 gm. in watery solution and this may be repeated daily. 

 According to Zahns five to ten drops of a 1 per cent solution may 

 be given three times a day. Arecoline may be used in some cases. 



Puncture is indicated in cases where the quantity of liquid 

 is more considerable and this may have to be repeated on ac- 

 count of the appearance of symptoms of dyspnea. In less se- 

 vere cases this treatment yields good results, inasmuch as after 

 the removal of a part of the liquid there is pronounced im- 

 provement or even a complete disappearance of the condition 

 for a time. Even repeated tapping is borne moderately well if 

 it be possible to compensate for the loss of albumin by suitable 

 nourishment. 



Tapping is practiceil at the lowest part of the abdomen with the animal in 

 the standing or if necessary in the prone position. After proper preparation of 

 the seat of operation (shaving and washing of the skin with alcohol or ether) 

 the abdominal wall is pnnetnred with a sterilized troehar of not too wide a 

 bore, or with the needle of a hypodermic syringe. The stiletto is withdrawn and 

 the tap of the canula closed. To the camila is attached a long piece of rubber 

 tubing, the free end of which is put into a clean glass vessel placed on the ground. 

 The cock is then opened and the liquid allowed to run out. If the flow ceases 

 movements are made with the canula in order to displace the piece of mesentery 

 or loop of intestine that is causing the obstruction. Should this prove unsuccess- 

 ful the rubber tube is removed and a sterile probe is introduced in order to remove 

 any pieces of fibrin that may be sticking in the canula or to displace any organ 

 that may be covering the opening of the canula. When the liquid has been with- 

 drawn the wound in the abdominal wall, which is as a rule covered by the skin 

 which was displaced before the deeper layers were penetrated by the troehar, is 

 sealed either with collodion or with a pledget of wool soaked in pitch. It appears 

 to be advisable to put on a pressure bandage. Dieulafoy's suction pump may be 

 used for the withdrawal of the licjuid. 



Tapping needs to be carried out with care and as slowly as possible as a too 

 rapid removal of the liquid may lead to rupture of blood vessels, dangerous dis- 

 turbances of function of the heart or acute cerebral anemia. Should there be a 

 sudden appearance of symptoms of collapse during tapping this must be stopped 

 immediately and injections of ether or camphor given, and if necessary black 

 coffee may be administered. At each subsequent tapping a fresh seat of operation 

 must be selected. 



To prevent fresh effusion of liquid, French authors (Pressecq, Sansot) advise 

 intraperitoneal injections of tincture of iodine or Lugol's solution. This treatment 

 ought to give the best results in a primary case, but it is dangerous in that it may 

 cause a rapidly fatal peritonitis. More recently the intraperitoneal injection of a 

 1 in 5 solution of choral hydrate solution has been advised by Sendrail & Cuille. 

 Directly a portion of the transudate has been removed from the abdomen a syringe 

 is connected to the rubber tube and the sterilized watery solution is introduced (about 

 1 gm. per 3 kilograms body weight). As a rule several injections are necessary at 

 increasing intervals. The authors record good results with this treatment. 



Omentopexia (Talma's operation in human surgery) is also recommended by 



