The Abdomen 201 



with tenesmus, rectal polypi, hemorrhoids, urethral stricture, en- 

 larged prostate, labor pains, and the injection of superhot or irri- 

 tating clysters, may lead to eversion of several inches of the rectum. 



In some instances portions of the colon or even the small in- 

 testine may form the protrusion. The importance of accurately 

 determining whether such is of local origin or not, is shown by the 

 experience of Walley. A three-months' old St. Bernard was de- 

 stroyed after all the usual methods of effecting permanent reduction 

 had failed. At the necropsy it was established that some ten inches 

 of ileum had been forced through the ileo-cecal valve into the rectum 

 and the supposed rectal procidence was in reality an instance of 

 ileo-cecal invagination, which could only have been treated by 

 abdominal section. 



Symptoms and Diagnosis. Simple prolapsed mucosa is easily 

 recognized as such. A typical protrusion presents the appearance 

 of a curved cylinder with the mucous membrane considerably 

 swollen. At the apex and in the center of the cylinder is the orifice 

 of the canal. In the early stages the protruding tissue is covered 

 with mucus and prone to bleed on coming in contact with any 

 rough surface. In the later stages the mass is more or less in- 

 durated with patches of ulceration and gangrene, particularly at 

 the dependent extremity. The passage of semi-solid feces is pos- 

 sible. 



Treatment. Simple prolapsed mucosa is best treated by linear 

 cauterization as follows : Seize it in five or six places with as many 

 pairs of forceps, draw it out and make three or four radiating 

 stripes with the cautery through the mucosa only. 



Procidence of the rectum is one of the most intractable mis- 

 haps in canine surgery. When the everted rectum has not become 

 congested it is not a very difficult matter to return it to its proper 

 position with the assistance of a little lubricant. By a digital 

 kneading process, commenced at the extremity of the protrusion, 

 the latter is gradually worked into the lumen. Replacement having 

 been effected, the next difficulty is to prevent further eversion. For, 

 recurrence of the trouble is very prone to take place, sometimes 

 shortly afterwards, at other times several hours later. Various 

 contrivances have been used as preventive means. The tobacco- 

 pouch stitch to constrict the anal opening, has been much used, but 

 very often it is efficient only as long as it is allowed to remain. 

 Degive recorded an instance of procidence, in which he made three 



