THE THORACIC AND ABDOMINAL WALLS i6i 



of such cases must always be grave on account of septic 

 dangers ; but numerous instances of recovery are on record, 

 and the owner should certainly be encouraged to make some 

 attempt to save the patient's life. The prolapsed organ 

 should be returned and held in place by the hand covered 

 with a clean handkerchief or other cloth, until an assistant 

 can adjust something to act as a temporary retention bandage. 

 The sooner skilled professional aid is obtained, the better the 

 chance of success. The patient should be put on the operating- 

 table and chloroformed, the parts thoroughly washed with 

 warm antiseptic and returned, the external orifice being 

 sutured as described for laparotomy (see p. 159). If the gut 

 is, or has, been exposed, a careful search should first be made 

 for perforations, and these closed by Lembert's sutures (see 

 p. 54). In the case of omentum, the protruding portion had 

 better be removed altogether, as this lessens the chance of 

 infection, and the absence of even a large piece of it will 

 not be of vital consequence to the patient (see p. 218). 



A greyhound, four years old, attempted to clear some spiked railinys 

 near Hyde Park, and became impaled on the top, staying there until 

 released by friendly hands. When lifted down, it was seen that a bunch 

 of intestine as large as a cocoanut had escaped. The owner, a lady, 

 holding a handkerchief over the wound and the protruding bowel, had 

 the patient carefully lifted into a cab, and arrived at the infirmary within 

 ten minutes after the accident. The dog was placed on the operating- 

 table in the dorsal position and chloroformed ; the intestines, visibly 

 soiled, were carefully washed with warm chinosol solution (i grain to 

 the ounce), and returned to the abdomen ; the edges of the wound being 

 similarly treated and then sutured in separate layers with silkworm gut. 

 The patient gave very little further trouble, and made an excellent 

 recovery. 



With g"unshot wounds of the abdomen, if extensive but 

 not yet fatal, the patient is usually in such agony that it is 

 better to destroy the animal as speedily as possible. If slight, 

 it is questionable whether it is wise to interfere surgicalh' 

 beyond the application of antiseptic external dressings (see 

 p. 50), rest, and the dietary prescribed on p. 160. It must be 



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