ENTEROCENTESIS 45 



voidable and beyond the reach of any effectual treatment. 

 Their arrest must be spontaneous. 



Bleeding from the abdominal wall by breaching one of its 

 vessels is likewise unavoidable, and whilst not as serious as 

 a haemorrhage in the bowels, the blood sometimes dissects 

 its way between the abdominal muscles and accumulates in 

 quantities at certain points, to the decided benefit of any 

 pyogenic microbes that might accidentally enter this favora- 

 ble environment. Blood from this source may also flow into 

 the peritoneal cavity and provoke or at least augment a local 

 peritonitis. This accident is managed by allowing the blood 

 to flow freely outward on the surface of the body, instead of 

 arresting it by digital pressure. If exceptionally profuse it 

 is even advisable to enlarge the cutaneous orifice and await 

 its spontaneous arrest, in order to prevent its onward dissem- 

 ination or accumulation between the layers of the ventral 

 wall. 



(2) Shock sometimes supervenes enterocentesis by the 

 sudden resumption of the splanchnic circulation after the 

 tension, which dammed the blood into other parts of the 

 body, is eliminated. The sequel is favored by general ex- 

 haustion of the vital forces that accompanied colic of long 

 duration. A nominal distention of long duration is much 

 more dangerous from this standpoint than an extreme dis- 

 tention of short duration. The capacity of the intestinal 

 vessels is enormous and they are very elastic. If the intesti- 

 nal blood is forced into other parts of the body for hours 

 while the ravages of the disease undermine the general 

 vitality and embarrass the heart at the same time, the 

 splanchnic vessels which have been stretched, weakened, 

 paralyzed, by the distention, are in no condition to cope with 

 the sudden rush of blood into them. They over-fill at the 

 expense of the periphery and to the decided detriment of the 

 already embarrassed heart. The totality of this disturbed 

 equilibrium is shock with all of its typical manifestations, — 

 coldness of the surface, cold perspiration, accelerated res- 

 pirations, pallor or cyanosis of the visible mucous mem- 

 branes, emptiness of the peripheral arteries, imperceptible 

 or thready pulse, tremors, cessation of the colicky pains, and 

 finally an early death. This accident of enterocentesis is seen 

 often in aged horses, and generally in colics that have dom- 

 inated for some hours. It is rare in the acute colic of the vig- 

 orous subject. 



Whilst not always avoidable shock may sometimes be 

 prevented by evacuating the gas very slowly, by applying an 



