The Abdomen 167 



time, and the mass may be more easily disintegrated and softened. 

 The water should be injected by means of a bulb syringe, as a 

 fountain syringe lacks the requisite force. It has been a matter 

 of observation that if a considerable volume of water can be 

 conducted beyond the obstructing mass the bowel will often be- 

 come sufficiently distended and stimulated to produce evacuation 

 without any further assistance. The instrument referred to being 

 of good length and fulfilling the part of an irrigator may 

 be employed to achieve this object. Rectal forceps are also useful. 



In one instance where the impaction was in a Great Dane 

 and I was experiencing, considerable difficulty in effecting its re- 

 moval with instruments, a small boy was employed to pass his 

 hand, well-oiled, within the rectum and seize and withdraw the 

 coproliths one at a time. 



It is advisable to persevere with rectal clysters and purgatives 

 administered per orem until vomiting absolutely precludes their 

 employment, particularly when any progress at all of the impac- 

 tion towards the rectum is noticeable. It is well-known that foreign 

 bodies and coproliths may take weeks to travel but short distances. 

 By daily removing the mass collected in the rectum with the for- 

 ceps or scoop, the accumulation lying on the proximal side of the 

 same has a chance to gradually work its way onwards, and this it 

 generally does, although it may take severel days to do so. 



When impactions are beyond reach per anum there is small 

 hope of affording relief without operative procedure of a major 

 nature. The advent of pronounced vomiting, is the chief diag- 

 nostic symptom warranting surgical interference by celiotomy. 

 Thereafter purgatives should be strictly avoided, for further pro- 

 longation of temporising therapeutics is, as a rule, utterly useless. 

 Nothing is retained by the animal's stomach, and its strength is 

 rapidly impaired. It is a mistake to await stercoraceous vomiting, 

 which is evidence that the impaction has alreadv been of some 

 duration, and that collapse is imminent. 



After the abdominal cavity has been opened and the rectum 

 reached, an attempt should first be made to force the mass along by 

 determined but not too forcible manipulation, in order that it may be 

 extracted through the anal orifice. The latter part of the opera- 

 tion should always be conducted by an assistant, so that the opera- 

 tor's hands may not become soiled. In this manner by persistent 



