Injuries of the Ureters. 253 



felt to be firm and resistant up to the period of rupture of the 

 ureter. 



In case of obstruction by calculus, crystals and even small cal- 

 culi may be passed in the urine, there is usually a history of 

 previous attacks of renal colic, and the suffering is manifestly ex- 

 treme. In case of worms (strongylus gigas) the use of the cen- 

 trifuge on the urine, may possibly secure in the sediment speci- 

 mens of its ova. The existence of tumors or tubercles can usually 

 be clearly made out. 



Treatment will be as varied as the lesion. Simple ureteritis 

 may be met by wet compresses, sinapisms, and internally by bal- 

 sams and anodynes. Calculi and parasites may be passed with 

 some aid perhaps from fomentations, antispasmodics, and diluents. 

 Obstinate cases can only be successfully met by surgical interfer- 

 ence. The resulting wounds in the ureter, like ruptures, perfor- 

 ating ulcers and strictures may be met by Van Hook's " lateral 

 implantation ' ' ; the divided cystic end of the ureter is ligatured 

 and on the cystic side of the ligature a longitudinal incision is 

 made, large enough to admit the divided extremity of the renal 

 portion, and through each of the two sides of this last a fine liga- 

 ture is passed ; these ligatures are then passed into the lumen of 

 the cystic portion of the ureter through its longitudinal incision 

 and brought outward through its walls ; next the renal end is in- 

 serted into the incision in the cystic end and the two are firmly 

 sewed together by the two ligatures. When a small portion of an 

 ureter must be excised it may sometimes be possible to save a val- 

 uable animal by such an expedient. 



In some cases of rupture into the vagina or uterus a'n available 

 fistula may sometimes be established into one of these. 



