70 DISEASES OF THE DIGESTIVE APPARATUS. 



The stenosis of the bowel that is caused by the injection of for- 

 eign bodies is best treated with laxatives and not with purgatives; 

 and, if a positive diagnosis has been made, it is best to perform 

 laparotomy with enterotomy as soon as possible, and not to wait 

 until gangreue and peritonitis have set in. 



According to Siedamgrotzky, enterotomy is performed in tlie following 

 manner : Make an incision on the linea alba, and, having located the part 

 of the intestine, pull it through the opening and hold the lips of the wound 

 together. Make the cut longitudinally on the intestinal line, remove the 

 foreign body and prevent at the same time any of the fluids escaping into 

 the abdominal cavity. The operator now takes a iine curved needle and 

 fine catgut and puts in a number of stitches through the muscular and serous 

 tissues, taking care not to go through the mucous membrane, so that when 

 the thread is tightened the two edges of the cut will be brought so as to 

 face into the intestine ; these are tied, and another line of stitches is made 



Fig. 19. 



Sature of the intestines. 



over the first, as is illustrated in the accompanying cut (Fig. 19). The 

 intestine is returned to the cavity, and the wound sewed up with silk and 

 dressed with an antiseptic dressing. 



The opening of the abdominal cavity is also to be performed in 

 cases where we can recognize a total constriction of the bowels. 

 In all those cases where the anatomical cause of the disease cannot 

 be clearly established we have no other way to proceed than to 

 treat the symptoms as they present themselves — that is, to give 

 purgatives, or, if there are great irritation and fever, give opium or 

 morphine; but in any case do not neglect to give plenty of watery 

 clysters. 



The general treatment must be directed toward keepiog up the 



