518 TREATMENT OF BOWEL FISTULA. 



in a nine-year-old mare. The fistula had resulted from an external 

 injury. 



Symptoms and course. Animals, with intestinal fistula, may 

 survive a long time, and, if liberally fed, may even remain in good 

 condition, though the constant discharge constitutes a blemish. 

 Urban kept a foal under observation for two years. In spite of 

 generous feeding it remained thin, and on that account was finally 

 killed. In another case recovery took place. 



Treatment should be directed to preventing discharge of bowel 

 contents, which is the chief obstacle to healing. Korber succeeded 

 by passing a red-hot wire into the fistula, after which cicatrisation 

 occurred in twelve days. Lindenberg recommends a purse-string 

 suture, inserted as deeply as possible so as to bring together the 

 inner end of the fistula, i.e., the opening into the intestinal wall. 

 It is not sufficient to close the external opening by bringing the skin 

 together, as new abscesses continually form. Dammann used sutures 

 in one case, but attacks of colic occurred and caused the ligatures 

 to tear out, and as the animal was no better after five months' 

 treatment, it was killed as incurable. Where the opening is small, 

 dressing with irritants, or the use of the actual cautery, may cause 

 swelling of the edges and union ; but should this fail, a strong thread 

 may be passed through the muscular walls of the abdomen. 

 Dammann cured the second case in two months by using liquor 

 Villati, applied on a mass of tow and kept in position with a bandage. 

 Should the injured portion of bowel have become adherent to the 

 abdominal wall, a section may be excised and the divided ends united 

 by sutures, or in the case of small animals by using Murphy's button 

 or a tube of decalcified bone. 



IV.— PARACENTESIS ABDOMINIS (PUNCTURE OF THE ABDOMEN). 



Serous fluid collects in the peritoneal sac in consequence of chronic 

 inflammation of the peritoneum, or more frequently of disease of 

 the kidneys, liver, or disturbance of cardiac circulation, and may 

 require to be removed by tapping. The peritoneum certainly 

 possesses the power of rapidly taking up large quantities of fluid 

 and returning them to the circulation, as clinical and experimental 

 observations have shown ; and these facts accord with our conception 

 of the peritoneal cavity as a great lymph-sac. When, therefore, 

 fluids remain for long unabsorbed, some special cause must be at 

 work, and as that cause is not removed by draining away the fluid, 

 the latter usually returns after a short time. For this reason the 



