194 CANINE AND FELINE SURGERY 



the sixth case the patient was only five weeks old, and 

 succumbed to obstruction of the gut from formation of 

 adhesions between the line of coalescence and a portion of 

 the bowel wall immediately beyond, this giving rise to an 

 acute curvature of the gut. 



Of the various mechanical devices for facilitating the 

 anastomosis of the divided ends of the intestine after enterec- 

 tomy, the metallic button invented by Murphy of Chicago 

 (see Fig. 131) is probably the one which has attracted the 

 most notice amongst surgeons during the past few years. 

 The advantages claimed by Dr. Murphy are that — ' (i) the 

 button dispenses \\ith the need of sutures ; (2) the possibilit}- 

 of non-apposition is prevented ; (3) the danger of sloughing 

 is avoided ; (4) the too rapid digestion of the catgut sutures 

 is prevented ; (5) the operation being more rapid, prolonged 

 anaesthesia is avoided ; (6) the great ease of the operation 

 renders the instrument as safe in the hands of the ever\-day 

 practitioner as in that of the most dexterous specialist.' 



All who have used it have not found these ad^•antages. 

 After a course of experimental work on dogs, Jordan speaks 

 of ' the danger arising from the presence of the large metallic 

 button, and the risk of gangrene spreading further than is 

 necessary, in Murphy's operation.' Harrison Cripps'^ speaks 

 very strongly against its use in human surger}-, his experience 

 leading him to directl}' opposite conclusions to those of 

 Murphy, whereas others speak very highly in its favour. 



It is placed and fixed in position as follows : A continuous 

 running thread is passed in and out completel}' around each 

 end of the intestine in a manner similar to the ' puckering 

 string ' or ' draw string ' of a bag ; the male half of the 

 button is placed in the distal end of the bowel, and the female 

 half in the proximal end, being held there b\' an assistant ; 

 the silk is then drawn up around each stem of the button 

 and tied securely. The two halves are steadily and firmly 

 ' ' Ovariotomy and Abdominal Surgery,' p. 281. 



