516 TREATMENT OP INJURED BOWEL. 



blood indicates injury to the stomach. A dog had a penetrating 

 abdominal wound, associated with prolapse of the bowel, which 

 was replaced and the wound sewn up by a layman. In subsequently 

 operating for the rupture, the bladder was cut into. After it had 

 been sewn up and a ligature passed round the hernial sac, both healed. 

 Ponfik's latest researches show that, although most injuries to the 

 liver end in death, yet they are not necessarily fatal. 



Stockfleth collected statistics concerning the progress of abdominal 

 wounds, complicated with prolapse of the bowel. In twenty-seven 

 abdominal wounds, prolapse was noticed fifteen times. Of fourteen horses, 

 two mules, two cows, and one dog, two horses, one cow, and one mule 

 died. This result gives, however, no indication of the relative gravity 

 of these abdominal wounds, the successful cases apparently having been 

 selected for publication. The course is usually less favourable. Jewsejenko 

 saw thirty-one abdominal wounds in the horse during the Russo-Turkish 

 war. Those caused by large projectiles were the gravest. The smaller 

 the projectile, the less the danger. Of eight horses with shot- wounds 

 injuring the bowel, five died with peritonitis ; three recovered after suturing 

 the wound. Two wounds of the stomach, produced by splinters of granite, 

 led to death. One wound of the stomach from a ball was sutured and 

 healed. Of four wounds of the liver, three were fatal ; one case recovered. 

 Of three wounds of the spleen, two ended fatally ; one recovered after 

 the projectile had been removed with dressing forceps. 



After penetrating wounds of the abdomen, animals, like men, 

 sometimes die rapidly from collapse. It was formerly believed 

 that this peracute progress was owing to shock ; but more recently 

 it has become evident that the real cause is profuse bleeding into 

 the abdominal cavity. This must be borne in mind, and in recent 

 injuries the pulse and mucous membranes must be examined before 

 giving a prognosis, or attempting operative interference, which may 

 be blamed for the animal's unlooked-for death. 



In order to study the effect of injuries produced by pistol bullets dis- 

 charged into the abdomen, Parkes experimented on thirty-seven dogs ; 

 three died immediately from bleeding from the aorta, or from the renal 

 or splenic arteries ; twelve lived for one day, and then died from bleeding, 

 with appearances of shock. The others lived longer ; but in almost all 

 the bowel contents obtained entrance into the peritoneal cavity, though 

 they could not be detected in the skin wound. Of the twenty-one which 

 did not immediately perish, two died from peritonitis. Of twenty-one 

 treated by laparotomy, ten died in from three days to three weeks, and 

 nine were cured. 



Chaput also produced experimental abdominal wounds and injuries 

 of the abdominal organs in dogs. Of those subjected to immediate treat- 

 ment the whole recovered ; where treatment was expectant only 32 per cent. 

 Chaput therefore recommended performing abdominal section in the middle 

 line, drawing forward and fixing the bowel by passing a director through 

 the mesentery, and .suturing the injured spot. Lanzillotti-Buonsanti 



