ENTERECTOMY. 



99 



(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 everyday practitioner as in that of the most 

 dexterous specialist. 



All who have used it have not found these advantages. 

 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 Crippsi speaks 

 very strongly against its use in human surgery, his experience 

 leading him to directly opposite conclusions to those of 

 Murphy. 



It is placed and fixed in position as follows : 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 by an 

 assistant ; a continuous running thread is passed in and out 

 completely around each end of the intestine in a manner 

 similar to the "puckering string" or " draw string'' of a bag! 

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

 tied securely. The two halves are steadily and firmly pressed 

 together, so that the two serous surfaces come in direct con- 

 tact. In from a week to a fortnight sloughing occurs of the 

 parts included within the button, and the latter is passed 

 through the bowel, union of the two serous surfaces having 

 occurred in the meantime. 



Jordaii,^ in India, performed enterectomy experimentally upon 

 fifty-nine pariah dogs by various methods, the one which gave 

 the greatest percentage of success being as follows : Two hollow 

 cylinders, each three-quarters of an inch long, were made either 

 from the decalcified femora of geese or turkeys, or from fresh 

 carrots, turnips, or potatoes, and bevelled off at one end so as 

 to form a hollow truncated cone, the apex being less than, and 



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



2 "The Lancet," October 1897, p. 1098. 



