B/SEASES OF THE RECTUM AND ANAL REGION 207 



Reduction and Minor Operative Interference. — If seen soon 

 after tfie trouble hias occurred, the patient should be 

 muzzled and put on a table of convenient height, the 

 protruding parts carefully washed with soap and water and 

 warm antiseptic (the hair around the anus being removed 

 with the scissors or razor), ana;sthetized with a 5 per 

 cent, solution of cocaine (see p. 26), and gradually kneaded 

 and manipulated with the ends of the fingers until it is 

 returned. Care must be taken that the mucous membrane, 

 which becomes very friable if prolonged exposure has taken 

 place, is not damaged by the finger-nails ; carbolic oil 

 or vaseline are useful adjuncts, and a thin cloth soaked in 

 antiseptic forms a useful protective, besides distributing 

 the pressure over a larger surface. \Mien the parts are 

 very swollen and hard to the touch, either hot fomentations 

 to relax the parts, or cold applications (such as ice) to the 

 gut to act as an astringent, are advisable. The former are 

 preferable when the case is seen earlv and the parts have not 

 become lacerated. When they have become friable, cold water 

 or ice should be used, as after their application the mucous 

 surface becomes stronger and better able to bear the pressure 

 which must, of necessit}', be put upon it. It is astonishing 

 how readily, after continuous fomentation for half an hour or 

 even less, the tissues of the anus and bowel will relax, and 

 enable the operator, b)' careful manipulation, to return an 

 apparently hopeless prolapse. It is alwa)'s wise, too, before 

 finall}- resorting to the use of the scalpel, to chloroform the 

 patient ; as this effectually overcomes the resistance offered 

 both by the voluntary movements of the animal itself and 

 the spasm of the anus. The kneading is done with the 

 ends of the fingers and thumbs of both hands, com- 

 mencing with the extremity of the prolapse, gradually 

 turning the edges into the lumen until only about an inch 

 remains outside, when the anus itself is also manipulated, 

 and with a final push the whole will disappear from view. 



