DISEASES OF THE DIGESTIVE ORGANS. 



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by the presence of hair-balls and other foreign bodies in the 

 stomach, by fever, choking, stricture or parasites in the gullet, 

 tuberculosis, etc. 



Syni/'toms. — Swelling of the whole left side of the belly, oAlmi 

 rising above the level of the hips and backbone, tense and 

 elastic recoiling at once when pressed in, and 

 drum-like on percussion. There is great diffi- 

 culty of breathing, distended nostrils, blood- 

 shot eyes, open mouth, drivelling of saliva, 

 occasional belching of gas with loud noise, 

 and frequent passage of dung and urine. 

 The patient stands to the last and falls to die 

 with ruptured diaphragm, or stomach, con- 

 gested lungs, and profound nervous shock. 



Treatment. — Gagging is alleged to succeed 

 as in choking, but I have not tried it. Dash- 

 ing a bucket of cold water on the body may 

 give temporary relief by condensing the gas 

 and favouring eructation. The hollow pro- 

 bang passed into the stomach as for choking 

 will allow the escape of the gas. In urgent 

 cases the paunch must be punctured with the 

 first instrument that comes to hand, and the 

 openings in the stomach and the skin kept 

 in apposition until the gas flows out. The 

 most suitable instrument is a cannula and 

 trocar at least six inches long, which may 

 be plunged without fear into the left side in 

 a downward and inward direction, from a 

 point equidistant from the hip-bone, the last 

 rib, and the lateral processes of the back- Fig. 19.— ivocar aad 

 bone. The trocar being withdrawn the 

 cannula may be tied in and left for hours or days. In tlie 

 absence of these a pocket-knife may be used, and should be 



