70 VETERINARY SURGICAL OPERATIONS 



visable to prevent straining from the irritation .of the rectal 

 mucous membrane, caused by the urine. 



TECHNIQUE. — The operation is exceedingly simple. 

 The hand, previously lubricated with vaseline, holding the 

 trocar and canula guarded in the palm, is passed into the rec- 

 tum about twelve inches at which point the bladder is found 

 conspicuously bulged and extremely tensed. The point of 

 the instrument is then advanced in front of the finger, tips, 

 and then pushed into the bladder in a slightly downward 

 direction, by a sudden forward thrust. The trocar is with- 

 drawn by manipulating it between the thumb and index 

 finger. It is essential that the trocar be well lubricated and 

 loosely fitted into the canula; otherwise its withdrawal with 

 one hand alone would be impossible. 



The rubber tube is then worked into the rectum with the 

 opposite hand and then fitted over the hilt of the canula, thus 

 completing a perfect siphon which will evacuate almost the 

 entire contents. 



SEQUELAE. — Cystitis may follow several repetitions of 

 the operation, but no noteworthy inflammation supervenes 

 a single puncture. Jones performed the operation more than 

 ten times on a yearling steer suffering from a urethral cal- 

 culus, and found on post-mortem examination some months 

 later that the bladder had undergone a severe acute inflam- 

 mation that became chronic and caused thickening and in- 

 duration of the whole or.gan, with a pronounced reduction of 

 its capacity. 



Shock. — Fatal shock may supervene the operation within 

 a few hours, especially if the case be one of long- standing. 

 An old gelding suffered from a complete stricture of the 

 urethra supervening a neglected frost bite of the penis, sus- 

 tained by sleeping upon a cold, bare floor on a very cold night. 

 A part of the organ sloughed off and the exposed urethra 

 gradually constricted until only a few drops of urine were 

 voided from the attempts to micturate. The obstruction 

 was, in fact, complete, as the rectal examination revealed an 

 enormously distended bladder. Preparatory to the removal 

 of the patient to the hospital for operation the bladder was 

 evacuated through the rectum, by means of an intestinal tro- 

 car and canula; but instead of giving the expected relief an 

 alarming state of collapse almost immediately supervened. 

 Tremors appeared at the shoulders, perspiration broke out 

 about the head, the respirations quickened, the pulse became 

 feeble and the whole body grew cold. These symptoms 

 gradually accentuated and ended in death about three hours 



