SURGICAL TREATMBNT 185 



a major operation of this description — one for which a 

 large fee must necessarily be demanded, and one which 

 will make or mar a great deal of the operator's 

 reputation — is severely relegated to the background of 

 ' possible,' but ' inadvisable,' remedial measures in cases 

 of equine intestinal obstruction. 



To my own mind there is only one of the intestinal 

 obstructions described in this volume that is at all likely 

 to warrant this extreme step being taken : that is the 

 obstruction occurring in the small colon. That con- 

 clusion is fairly justified by the following considerations : 



1. Professor Macqueen has covertly admitted that the 

 small colon is the most suitable bowel to operate upon, 

 its comparatively thick longitudinal band offering a suit- 

 able position for the incision and the after-placing of the 

 sutures. 



2. In the present state of our knowledge, the diagnosis 

 of these obstructions is not sufficiently clear to justify us 

 in operating unless the obstruction has been positively 

 lelt per rectum. I have already shown, in Chapters X. 

 and XI., that an obstruction of this size felt per rectum is 

 most likely to be in the small colon. 



3. Should the obstruction be demonstrated to exist in 

 the large colon, we have to face two serious factors 

 largely operating against the chances of successful 

 surgery : (a) The extreme likelihood of the obstruction 

 being of so large a size as to necessitate a very large 

 incision in the bowel wall, (b) The comparative thin- 

 ness of the walls of this portion of the intestinal tract, 

 which would render the placing of safe sutures a matter 

 of considerable difficulty. 



When all is said, the veterinarian may remember this 

 much with safety: Whatever may be his doubts con- 

 cerning his diagnosis, whatever anyone else may urge to 



