IMPACTION OF INTESTINE. 95 



the past twelve months, in two of which the animals (retrievers) 

 had passed no feces for at least three weeks. 



The obstruction usually occurs in the colon, and it may- 

 extend upwards for a considerable distance into the small 

 intestine. In one of the retrievers above-mentioned fully a 

 foot of intestine was involved by a mass as hard as a stone, 

 the small intestine in front being enormously dilated and full 

 of semi-fluid faeculent material. 



Surgical aid is rendered after all efforts to remove the 

 impaction by medicines given by mouth or rectum have failed. 

 The simplest plan consists in the injection of melted lard or 

 warm oil per rectum, and the removal of as much as possible, 

 bit by bit, with the fingers or a blunt spoon. This can be 

 done to a certain extent, but often the lump is out of reach, 

 and matters become more serious. Laparotomy must be per- 

 formed and the obstructed bowel massaged and kneaded 

 gently but firmly, until its contents break up into fragments 

 of sufficiently small size to be passed on into the rectum ; 

 they are then removed by an assistant. 



The process of kneading must be done very patiently with 

 the ends of the fingers and thumb, great care being taken to 

 avoid injury from the nails ; it is a good plan to try first at 

 one end and then at the other, gradually working towards the 

 centre, or any place that feels softer than its surroundings. 



A third plan consists in opening the bowel and removing 

 the obstruction in that way (see enterotomy), the operation 

 being i-endered more risky than in an ordinary case on account 

 of the large accumulation of fluid feculent matter, and the 

 lax, debilitated condition of the serous and muscular coats of 

 the intestine ; the latter in particular rendering the insertion of 

 sutures without tearing a matter of very careful and delicate 

 manipulation. 



The prognosis when the hardened faeces can be removed by 

 the spoon alone is good, the only after-treatment necessary 

 being the injection for a few days of some emollient antiseptic. 

 When the case has progressed so far that laparotomy or entero- 



