THE DIGESTIVE SYSTEM. 283 



ing posture, with the left side against a wall. An in- 

 cision is made, large enough to admit the hand, down- 

 wards from the point opposite that of puncture of the 

 rumen, and the muscles are first divided ; subsequently 

 the peritoneum is perforated, and the hand is introduced 

 and passed upwards and backwards to behind the kidney, 

 where the remains of the cord may be felt and traced down- 

 wards. The bowel may be then gently drawn away, but 

 if it does not yield to very mild traction a probe-pointed 

 bistoury must be passed in, and the adhesion of the cord 

 to the abdominal ring divided, to prevent recurrence. 

 This is generally sufficient to permanently effect relief; 

 the colicky pains cease, and a free discharge of faeces 

 takes place. We need not further describe the operation, 

 for the abdominal incision must be closed in the usual 

 manner. 



Peolapsus differs from hernia in that the protrusion 

 occurs through one of the natural orifices. The rectum is 

 the only bowel which can thus become displaced, and cases 

 of this are not uncommon. The causes are, violent strain- 

 ing, such as is symptomatic of the various conditions which 

 cause obstruction of the intestinal passage ; also, it some- 

 times results from parturition throes, or where impediment 

 prevents evacuation of the bladder. After protrusion the 

 part becomes strangulated, assumes a bright-red colour, 

 and then becomes very much enlarged by gelatinous ex- 

 travasation between the intestinal coats ; subsequently it 

 becomes cold and purple. 



Treatment. — If possible, remove the cause of straining ; 

 then carefully clean the protruded bowel by washing it 

 with cold water, after which apply even pressure over the 

 organ, gradually returning it from the centre. There is 

 no serious objection to diminution of its bulk by scarifica- 

 tion. If all measures prove unsuccessful, and the organ 

 becomes purple, it may be amputated, and the edges of the 

 two cut portions of the bowel united together by sutures. 

 Subsequently anodyne agents, as opium, may be given, 

 and the diet be soft for some time. This lesion is some- 

 times termed j^roZa^Jsits ani. 



