PROLAPSUS ANI. 413 



troublesome does the return in some of these cases become, 

 tliat it is necessar}^ to contrive some sort of truss to oppose 

 the descent, the same as is done for rupture in man. Mr. 

 Dycer^s truss consisted of " a new wet chamois leather, a 

 breast-plate, arid a hip (human) truss/' Should constipa- 

 tion be thought to operate against reduction, in addition to 

 clysters, we may exhibit cathartics and aloes in solution, and 

 should there be plethora and great irritability in the mem- 

 brane of the rectum and anus, a bloodletting will be ad- 

 visable ; while an opiate or belladonna clyster will be advan- 

 tageously administered in order to allay all local irritation as 

 much as possible. 



As a dernier and eflPective mode of procedure in 

 prolapsus ani, when the case proves either irreducible or, 

 after return, continually protrudes, on any slight effort, such 

 as coughing, afresh, we have recourse with safety and cer- 

 tainty to an operation consisting in excision of more or less 

 of the inverted membrane enveloping the protruding portion 

 of gut. This is an operation of ancient date, though to 

 Dupuytren is ascribed the credit of introducing it into 

 human practice, and to the French veterinarians that of 

 transplanting the same into veterinary practice. Formerly 

 the actual cautery was the instrument employed for the re- 

 moval of the parts obstructing reduction ; but in our own day 

 this has been thrown aside for the scalpel, an instrument 

 quite as effective, while the simple act of cutting with a knife 

 gives so much less pain than cutting or dividing with the 

 actual cautery does. In general, it is considered necessary 

 to cast the horse for the operation; but Mr. Gregory, V.S., 

 Bideford, '' did not cast the mare, but merely put on a side 

 line, and had one leg held up, and the tail kept on one side ;" 

 and most assuredly the standing position of the patient is one 

 which, in such an operation, offers no mean advantages to 

 the operator, providing he can avail himself of it without any 

 personal danger. A great preservation against refractori- 

 ness in an operation of the kind, at the moment when any 

 pain is felt, is a twitch well put on and well and timely 

 turned. The horse secured, and the tail turned aside out of 



