f>74 PUNCTURE OF THE BOWEL. 



necrotic or acutely inflamed, it may be resected, care being taken 

 to operate in sound tissue. A triangular piece of mesentery having 

 the bowel for its base is at the same time removed. The ends of 

 the bowel are then turned inwards and the opposed serous surfaces 

 united by means of numerous fine silk sutures. McQueen used 

 cambric needles and fine sterilised silk. The best form of suture 

 is probably Lembert's. A second series of sutures is then inserted 

 1(» strengthen the union by extending the surface of contact of the 

 serous coats. As shown by Dollar's experiments, adhesion of the 

 serous surfaces is remarkably rapid. To shorten and simplify the 

 process of uniting the serous coats Murphy introduced a " button " 

 in two parts, one of which was inserted in each end of the bowel 

 and secured by passing a tobacco purse stitch around the periphery 

 of the bowel. When pressed together the two extremities of the 

 button automatically engaged and kept the two serous surfaces 

 of the bowel firmly in contact. In four to five days the button became 

 loosened in consequence of those portions of bowel included within 

 it undergoing necrosis, leaving a circular line of union around the 

 bowel. The button was passed per rectum. 



Murphy's button has often been successfully used in dogs ; Murphy 

 himself made more than 600 experiments, but McQueen's experiments 

 on horses failed, and in these animals the method cannot be recom- 

 mended. Decalcified bone tubes might be useful in the larger 

 animals. 



II.— PUNCTURE OF THE BOWEL IN HORSES (ENTEROCENTESIS). 



In horses, colic is often accompanied by active production of 

 gas in the large colon and caecum, by which the diaphragm is pressed 

 forward and respiration impeded, the lungs being compressed and 

 the posterior ribs fixed. Suffocation may even be threatened, and 

 circulation in the abdominal viscera so affected as to endanger life. 

 The animal's recovery, therefore, depends on speedy removal of the 

 gas. The more marked the respiratory disturbance, the shallower 

 and more frequent the breathing, the greater is the danger. In 

 extreme cases the animals become unsteady on their legs, stagger, 

 fall down and die in a few minutes. Crib biting or wind sucking 

 induces the same symptoms, though in a minor degree, and seldom 

 leads to death, but tympanitic colic, produced by fermentation in 

 the intestinal canal, often takes a fatal course, the reason being that 

 in the one case air ceases to be swallowed as soon as the animal 

 experiences discomfort or pain, whilst in the other fermentative 



