64 VETERINARY SURGICAL OPERATIONS 



should be lanced as soon as fluctuation appears and then irri- 

 gated moderately with hydrogen peroxide three or four times 

 daily until their formation ceases, which is often as long as 

 five to six weeks. If the patient lies down too much of the 

 time special care must be taken to prevent decubitus, by 

 abundant litter and by the use of slings. 



This complication is mostly serious in the tarsal sheath 

 and in the sesamoidean sheath of the hind leg. In the fore- 

 leg and in the bursse of the extensor tendons it is much less 

 serious. 



Gastrocentesis. 



DEFINITION.— Gastrocentesis signifies puncturing th,e 

 stomach. It is applied here to designate the aspiration of 

 gases either from the. stomach or the rumen, by means of the 

 trocar and canula or other instrument. 



INDICATIONS.— Gastrocentesis is practiced chiefly on 

 ruminants, and is always indicated when the rumen is dis- 

 tended with gases in sufficient quantities to cause pronounced 

 distress. The disease, which is known as acute tympanites, 

 blown, hoven, etc., and which is the condition that calls for 

 this operative intervention, is a fermentation of rapidly in-' 

 gested feeds. Green fodders or grasses eaten ravenously in- 

 considerable quantities, indigestible slops or, in fact, any of 

 the ordinary feeds taken in too large quantities, are among 

 the many causes which may provoke such attacks. The dis- 

 ease is in reality an overloading of the rumen with feeds 

 which in turn still further distend the organ by elaborating 

 gases of fermentation. But the rumen is generally found full 

 of a semi-liquid, bubbling, churning mass of ingesta, through 

 which the gases are permeated so completely as to prevent 

 their immediate evacuation. That is to say, in acute hoven 

 the gases are intermixed with the mass, and cannot be ab- 

 stracted through a canula alone in sufficient quantities to 

 afford any immediate relief. The intra-abdominal pressure 

 in such cases can only be reduced by giving a free exit to the 

 ingesta and gas combined through an opening sufficiently 

 large to permit their passage. Gastrocentesis, -in the ordi- 

 nary sense of the term, is, therefore, not always an effectual ' 

 operation in the relief of distended rumens. Rumenotomy 

 may be necessary in those acute cases where the gases have 

 not separated from the mass of ingesta. When the rumen is 

 not completely filled with food and the upper part contains 

 gas elaborated from the food below, the relief from the oper- 

 ation is prompt; otherwise it is always very unsatisfactory be- 



