386 VETERINARY SURGICAL OPERATIONS 



fected transversely with the- scalpel, includes the skin and all 

 of the penis except the dissected urethra, which is left entire. 

 The amputation must always be made some distance from 

 the tourniquet, to prevent the latter from prematurely slip- 

 ping over the stump. The ecraseur may be used to amputate 

 instead of the scalpel, but serious haemorrhage may occa- 

 sionally result therefrom. The sinuses of the cavernous 

 body do not yield like blood vessels to the crushing effect of 

 the ecraseur and may therefore bleed copiously alter its use. 



Fourth Step. — Haemostasis. — Bleeding is preferably pre- 

 vented by ligating the stump. The stump, excluding the ure- 

 thra, is ligated by transfixing it through the center one-half 

 inch behind the section, and tying each half separately, or by 

 multiple ligatures if the stump is very' large. Another very 

 effectual method of ligation consists of first placing a tobacco- 

 pouch stitch loosely around the stump, then weaving a sec- 

 ond strand through the exposed loops, and then drawing the 

 two as tight as possible. The first prevents the second strand 

 from slipping off and the two together effect a perfect and 

 a safe haemostasis. These ligatures may be applied either 

 before or after the amputation. 



Searing the stump with a hot iron is also an effectual 

 method of controlling the flow of blood, but the cauterization 

 must be thorough. Slight cauterization will not answer. 



Fifth Step. — -Removal of the Tourniquet. — When assured 

 that the ligation or the chosen method of controlling the flow 

 of blood is safely completed the tourniquet is untied and the 

 stump allowed to retract into the sheath. The urethra, which 

 always contracts several inches towards the stump, is left 

 hanging out of the sheath orifice. 



AFTER-CARE.— The sheath is irrigated daily with an 

 antiseptic solution by means of a large syringe, a fountain 

 syringe or injection pump, until about the tenth day, when 

 sloughing of the ligated end leaves no further demand for 

 treatment. The hanging urethra gradually shrivels up or 

 sloughs off by sections until it has finally taken its place, 

 safely opened, at the new end of the penis. 



SEQUELAE AND ACCIDENTS.— The only untoward 

 sequel is stricture of the urethra, which universally occurs if 

 precautions to prevent it are not taken. Ordinary amputa- 

 tions which make no provisions to prevent strictures are ab- 

 solutely unsuccessful, and ampngst the various methods em- 

 ployed or described in veterinary literature the author has 

 found none so universally preventive as the one described 

 above, — that is, dissecting the urethra from the meatus to 



