ENTEROCENTESlS 47 



the skin and instruments. In the less urgent cases, and 

 especially when the operation was only performed once, this 

 sequel should seldom ever be permitted to occur. It savors 

 of uncleanly surgery. 



Sometimes, however, the infectious matter is brought 

 into the tract from the intestinal contents as the canula is 

 withdrawn. When the contents of the colon is a churning, 



fermenting mass, and the distention was not relieved from 

 the operation, there is always much danger that some of the 

 ingesta will follow the canula into its tract as it is withdrawn. 

 It even happens that froth and food particles will bubble from 

 the cutaneous orifice after withdrawal of the instrument. 

 In these incidents prevention is impossible, beyond the pre- 

 caution of replacing the trocar into the canula before with- 

 drawing it. 



The abscess from intestinal infection is differentiated 

 from the one from external infection by its greater size,. its 

 slow evolution, its great depth, its fetid contents, the necrotic 



| shreds in its contents, and by the frequent presence of the 

 bacillus pyogenes fcetidus (colon bacillus). This pus-pro- 

 ducing microbe, ever present in the intestines of horses, finds 

 a favorable environment for growth in the track of a canula, 

 and it is indeed frequent that it finds its way into the tract. 



The course of these abscesses is varied. After pointing, 

 or after their contents have been artificially evacuated by 

 lancing, they may cicatrize promptly and cause no, further 

 trouble. Sometimes, however, they may develop into 

 chronic fistula; that discharge for months, or that defy every 

 effort to locate their exact direction or perpetuating cause. 

 If the original orifice closes they may point as ,low as the 

 groin near the mammae or sheath. 



The abscess supervening enterocentesis should be 

 treated by early evacuation of its contents. Whatever may 

 be the proper course to pursue in regard to lancing abscesses 

 in general, this one should be ripped open at once as soon as 

 it is seen. This early treatment prevents dissemination, and 

 precludes the formation of fistulse. A good, liberal incision 

 is made into the forming sac, which is then treated with fre- 

 quent injections of hydrogen peroxide. Forcible irrigations 

 which would tend to spread out the infectious matter are 

 avoided. 



