BOWEL FISTULA. 517 



collected a large number of clinical records referring to various forms of 

 abdominal injury, from simple perforating wounds to such as involved 

 severe injuries of the contained viscera. Of eighty-three cases in solipeds, 

 sixty-five recovered and eighteen died ; five cases in cows all recovered, 

 as did four cases in pigs. Numerous recoveries from similar injuries have 

 more recently been recorded, thanks to antiseptic treatment. 



III. BOWEL FISTULA (ANUS PRETERNATURALIS). 



The term bowel fistula is applied to a direct communication 

 between the lumen of the bowel and the external air through the 

 abdominal wall. A probe introduced into the fistula passes through 

 the abdominal wall directly into the bowel. The opening may occur 

 at different points, but is generally found on the lower surface of 

 the abdomen, in horses often close behind the last rib. 



Bowel or gastric fistula— not infrequently produced for physio- 

 logical objects — may also result from accidental injuries penetrating 

 the abdominal coats, and Curclt related cases of the kind both in 

 the horse and the ox. Howard produced fistula of the colon in a 

 sucking pig, which was suffering from atresia ani, in order to save 

 the animal. If, in penetrating abdominal wounds, the intestine 

 is laid open, its edges may unite to the abdominal wound and external 

 skin, and produce a bowel fistula. Arndt, Lindenberg, Dammann, 

 and others have described such cases in horses and oxen. The injury, 

 however, sometimes originates in the gastric or intestinal mucous 

 membrane. The serosa becomes inflamed and firmly adherent to 

 the wall of the abdomen, and if now abscess formation occurs, the 

 abdominal walls may be perforated and a bowel fistula produced. 

 Korber saw a horse suffer in this way after an attack of colic. Per- 

 foration had occurred close to the middle line of the abdomen behind 

 the umbilicus. Urban reported a similar case in a foal, in which 

 an umbilical hernia had been opened, producing bowel fistula. Bayer 

 noted a like accident after dressing an umbilical hernia with nitric 

 acid. Fiirstenberg describes a fistula of the abomasum in a cow. 

 Seven to ten minutes after receiving water, a stream of fluid mixed 

 with food was projected several feet beyond the wound. Flourens 

 produced fistula of the rumen artifically for the purpose of studying 

 rumination in oxen and sheep, and Haubner saw gastric fistula in 

 sheep result from giving arsenic insufficiently powdered. Foreign 

 bodies swallowed by cattle often produce gastric fistula?, and perforate 

 the wall of the abdomen, or that of the thorax close behind the elbow, 

 but these generally heal. Strecke found one half of a pair of scissors 

 in the abscess. Dammann describes a case complicated with hernia 



