292 VETERLNAKY MEDICINE AND 8UKGEKY. 



become enlarged by the pressure of the contained viscera, and to cause 

 death by allowing the protrusion and escape of the intestines. 



Treatment. — The treatment for the first form must be conducted 

 with the view to allow the free escape of pus and other discharges, and 

 for this it may be necessary to dilate the external opening. This, how- 

 ever, must be done very carefully, or the second danger may be induced. 

 Very often the burrowing of the discharges is promoted by the drying of 

 the surface of the wound. This is more apt to prove injurious when 

 the hair is long, as the hair and dry discharge become matted together 

 over the opening, which is thus effectually jjlugged up. Care must be 

 taken that this does not occur, and for its prevention the hair must be 

 clipped round the orifice, and the parts carefully washed and kept clean. 

 If it is necessary to dilate the opening, the incision should be shal- 

 low, and along the long axis of the belly. When abscesses form, it is 

 always necessary that they should be opened early, as the fascia, being 

 very tough and elastic, allows extensive infiltrations or burrowing of the 

 pus. 



The deeper punctures must be treated with the view to prevent the 

 escape of the intestines. The discharges from them must be allowed 

 free exit; but whilst doing this, their extension by the weight of the vis- 

 cera must be jDrevented, and this may be done very effectually by inclos- 

 ing the body of the patient in a common bed-sheet, sewn firmly round 

 him. This will form a suitable support to the weakened walls, and at 

 the same time allow the escape of the discharges. Should it, however, 

 become clogged up by the coagulation of these, a small hole may be 

 made in it immediately below the wound. 



When the peritoneal cavity is actually penetrated, or even when it is 

 only nearly so, the medical treatment should be conducted with a view 

 to lessen the danger of peritonitis. Purgatives are to be withheld, and 

 should the pulse be at all disturbed, opium must be given, and the large 

 bowels unloaded by enemas; fomentations to the belly are to be perse- 

 vered in until the danger of inflammation is past. 



Incised wounds upon the belly are to be treated by strong sutures, 

 the collodion or shellac paste, and the broad-sheet bandage; but fomenta- 

 tions are not to be applied as in punctured wounds, as they would interfere 

 with the adhesive process, unless, indeed, the danger of peritonitis be 

 imminent. 



Purgatives should never be administered when the abdomen is 



