ENTEROCENTESIS . 41 



second or third operation, may, however, occasionally pro- 

 voke a resenting kick as the trocar is plunged into the flank. 

 While this incident is somewhat rare, the careful surgeon 

 will never so far forget the liability of its occurrence as to 

 expose himself to injury in any case. We once observed a 

 horse, that after having been submitted to the operation a 

 number of times during different attacks of colic, fought 

 viciously at the sight of the trocar and canula and could only 

 be controlled with the twitch and sideline. But such cases 

 are exceptional. By standing at a safe distance in front of 

 the reach of the hind leg no restraint will be found necessary 

 except in these rare cases. 



TECHNIQUE.— First step.— Locating the Seat of Oper- 

 ation. — The seat of operation is the right flank at a point 

 equally distant from the anterior angle of the ilium, the trans- 

 verse processes of the lumbar vertebras, and the posterior 

 border of the last rib. But this rule must not be followed 

 "to the letter" in every ins'tance ; some respect must be given 

 to the most prominent point of the distention, irrespective of 

 this classical measurement. The operation .may sometimes 



Pig. 22 — Intestinal Trocar and Canula (Encased) . 



be performed at the left flank when, in threatening cases, it 

 was found impossible to afford sufficient relief from the right 

 side. The relations of the bowels, when bloated, are often 

 changed, and thus leave little assurance that the colon or 

 caecum will always be punctured by penetrating the right 

 flank. A third seat of operation is the rectum. After futile 

 efforts to relieve the tension through either flank the caecum, 

 whose base pushes into the pelvic cavity when distended with 

 gas, may be punctured through the rectum with very satis- 

 factory results in many instances. 



Second Step.— Disinfecting the Field and the Instru- 

 ment. — Except in instances where the life of the patient is 

 in immediate danger, or when the patient on account of vio- 

 lent pain is too uneasy, great care should be taken to cleanse 

 the field and disinfect the instrument. In the urgent case, a bit 

 of lard, oil, vaseline or any unctuous substance at hand that is 

 reasonable clean is smeared over the seat of operation so that 

 the hairs at the point of penetration can be parted and thus 

 leave a denuded spot for the point of entrance. The instru- 

 ment in a few moments can be safely sterilized by passing it 



