SURGICAL TREATMENT 



[79 



the floating colon to pass through the wound. Besides, 

 if the incision is made at this point the wound does not 

 heal rapidly, and adhesion between its peritoneal surface 

 and omentum or bowel is|a probable complication. In 

 the horse, incision of the abdomen an inch or two to 

 the right or left of the linea alba is equally objectionable. 

 When the floating colon has to be opened, I prefer to reach 

 the bowel through the flank (see Fig. 12, p. 177). In open- 

 ing the flank I make three wounds before touching the 

 peritoneum. The first divides the skin, fascia, and external 

 ohiique muscle; the second the internal oblique; and the third 

 the transversalis (see Fig. 13, p. 178). The first starts at a 

 point 4 inches below the lumbar transverse processes, 

 midway between the angle of the haunch and the last rib, 

 and passes downwards and forwards for 7 or 8 inches. The 

 forward direction of this incision is opposed to all teaching, 

 but its advantage is conceivable. The upper hind limb 

 is unhobbled and drawn backwards. The wound gapes 

 and exposes the internal oblique muscle, which is then 

 cut with scissors in the direction of its fibres. A similar 

 opening is made in the transversalis. The third wound 

 exposes a layer of fat which is lined by peritoneum ; this 

 is pierced with the finger, and the opening is enlarged 

 with scissors in the direction of the transversalis wound. 

 ^Incision and Suture of the Bcwel. — So far I have only 

 opened the bowel at the middle of the longitudinal band, 

 where the wall appears strongest and most capable of 

 supporting sutures (see Fig. 14, p. 180). With sharp- 

 pointed elbowed scissors the gut can be punctured and 

 the wound extended without the slightest difliculty. The 

 wound is closed with sutures of prepared Chinese twist 

 No. I. There are many methods of suturing bowel 

 wounds, but Lembert's is the only one of which I have 

 experience. Sutures applied by Lembert's method pass 



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