INJURIES OF THE RECTUM. 597 



penetrating the mucous membrane. Stockfleth removed from the 

 anus of a cat a fish-hook, which had passed through the entire digestive 

 tract. Jansen found the skull of a foetus in a sow's rectum ; the skull 

 had, daring parturition, penetrated from the vagina into the rectum. 



The anus is also liable to be injured during delivery. The 

 perineum and, under certain circumstances, the sphincter ani may 

 be simultaneously ruptured ; in oxen, horn-thrusts are often respon- 

 sible for these accidents. 



The course of such injuries depends principally on their seat and 

 extent. Wounds penetrating the peritoneal cavity always end 

 fatally ; and those caused in mares and cows by pressure of the 

 penis are nearly as dangerous, though cows have been seen to recover. 

 On the other hand, sudden death attributable to shock has some- 

 times been noted. Mares may die within twenty-four hours ; cows 

 may survive longer. Passage of the penis into the rectum is not, 

 however, always followed by rupture— injury depending chiefly on 

 the degree to which the rectum is filled with fasces. Wounds from 

 the clyster syringe generally end fatally, and particularly if drugs 

 have entered the peritoneal cavity. 



Injuries of the posterior portion of the rectum lying beyond 

 the peritoneal cavity, though certainly not so dangerous as the above, 

 are yet apt to lead to septic cellulitis in the connective tissue around 

 the rectum (paraproctal connective tissue), and may be followed 

 by fatal consequences. But Hiippe's case shows that in the horse 

 even extensive injuries at this point may heal. Injuries of the vagina 

 are less dangerous, though sometimes followed by formation of recto- 

 vaginal fistula?. 



Diagnosis is at once settled by exploration of the rectum and 

 examination with the speculum, in cases in which colic, tenesmus, and 

 blood-stained discharge occur. But before proceeding thus to deter- 

 mine the seat and extent of the injury, it should be ascertained whether 

 manipulation of the parts has already been practised, and the owner 

 should be informed of the possible existence of a fatal injury, so that 

 the operator may not be suspected of having caused it. Complication 

 with peritonitis is characterised by fever, small and frequent pulse, 

 and slight but continuous colic, and in horses death occurs in a few 

 days, often even in a few hours. 



Wounds of the anus are only grave if the sphincter or perineum 

 is divided. If no difficulty occurs in closure of the anus, wounds 

 of this part heal easily and completely ; only exceptionally does 

 anal fistula result. The healing of ruptured perineum offers greater 

 difficulty and, in mares, may result in sterility, but a cure is usually 



