kltMEN. 



73? 



These various methods may lead to delayed complications, such as 

 dilatation or contraction of the mucous memhrane of the oesophagus, 

 muscular atrophy of the (.esophageal walls, cesophageal 

 fistula, and, sometimes, abscess formation. 



RUMEN. 



Two operations are currently performed on the rumen, 

 puncture and gastrotomy. 



PUNCTUKB OF THE EUMEN. 



Puncture of the rumen is essentially an urgent opera- 

 tion for the relief of acute and rapidly progressive tym- 

 panites. It is performed in 

 the left flank, at an equal 

 distance between the last 

 rib and the angle of the 

 haunch, and an inch or two 

 beyond the transverse pro- 

 cesses of the lumbar region. 



First stage. Incision of 

 the skin to the extent of 

 about one inch (not abso- 

 lutely necessary). 



Second stage. Puncture 

 with a sharp trocar directed 

 forwards, downwards, and 

 inwards. In making this 

 puncture the point of the 

 trocar is passed through 

 the incision, and a sharp 

 push is given. The sensa- 

 tion of resistance overcome 

 indicates that the trocar has 

 penetrated the cavity of the 

 rumen. Gas then escapes. 

 When the operation is com- 

 pleted, and the canula is 

 being withdrawn, care should 

 lip tpken to press down the 

 skin on eithe' side with the fingers of the left hand, to prevent acci- 

 dental U ting and laceration of the connective tissue. Even so sight 

 !n accident as this might cause serious complications at a later stage. 



In the absence of a trocar, and in cases of extreme urgency, the 



D.C. 



Fig. 301.— Trocar for puncture of the rumen. 



