THE URINARY ORGANS 245 



in order to evacuate the contents of the bladder when this 

 organ is over-distended. In addition to over-distension from 

 the presence of calcuh, this condition ma\- arise from any 

 excessive pressure on the neck of the bladder, such as is 

 met with in perineal hernia (see Fig. 153). 



The most convenient situation for operating is a spot in the 

 linea alba from about i to 3 inches (depending chiefly upon 

 the size of the animal) behind the brim of the pelvis, the 

 object being to pierce the bladder in a part where it is tense 

 and }-et fairl}- close to the neck. The patient is very gently 

 placed on the back or side, the bladder being grasped care- 

 fully but firmly through the walls of the abdomen with one 

 hand, and held as near the seat of operation as possible. 

 Havmg carefulh' shaved off the hair, under antiseptic pre- 

 cautions a trocar and cannula (\\hich should be of a fine bore) 

 are inserted subcutaneousl)- for a short distance, and then 

 directly into the bladder. The trocar is withdrawn and the 

 urine allowed to escape. After-treatment consists in with- 

 drawing the cannula carefully, dr3-ing the surface of the 

 wound and covering it with iodoform (or orthoform) and 

 collodion. 



It is risk}' to administer a general anesthetic in the 

 majorit}' of these cases, or even to fix the patient firmly, 

 because, if the bladder is much distended, rupture or sudden 

 collapse is apt to occur during the struggling ; the author has 

 seen this happen in three instances. As regards sequelae, in 

 so far as the operation itself is concerned, if antiseptic pre- 

 cautions are observed, no evil results need be feared. It can 

 be depended upon to give great relief, and, if the patient is 

 not too much exhausted or the cause of the distension is not 

 some permanent obstruction in the urethra or neck of the 

 bladder, the benefit is usually immediate and permanent. 



By way of illustrating the slight element of risk when the bladder is 

 punctured under strict antiseptic conditions, attention may be drawn to 

 the patient in Fig. 153. The operation was performed five times within 



