The Abdomen 241 



rial which penetrated, as is the rule with all foreign bodies, sooner 

 or later became the seat of deposit of urinary salts. Accordingly, 

 sutures must only be made to take up serous and muscular coats. 

 In other words, the proper method is that of sero-musculosa — sero- 

 musculosa, with inversions of the margin of the wound. This 

 method utilizes the well-known plastic activity of peritoneal surfaces, 

 which exceeds by far that of primary union of wounded muscular 

 tissue. It is important that sutures be applied not too far apart. 

 The extent to which the bladder will contract under the stimulus 

 of section is quite remarkable, being fully one-half the former capac- 

 ity, and sutures placed apparently at sufficient distance from each 

 other while the viscus is in this condition will be altogether too far 

 apart when it is distended with urine. Sutures placed at a distance 

 of 2 mm. from each other will be at 3 mm. after distension. A 

 single row of sutures suffices in simple cystotomy or after resection 

 of small portions of the wall, although this may be reinforced with 

 a second one at the discretion of the operator. Znamensky found 

 a double row imperative in cases where he resected the greater por- 

 tion of the organ. Vincent advises that the operation be supple- 

 mented by urethral injections of some colored fluid, such as milk, 

 with sufficient force to distend the organ. This affords means for 

 detection of permeability of the sutured surface, in which case a 

 second row of sutures must be inserted. 



After suturing, the catheter should be used at least twice daily 

 until normal micturition is established, not on account of the opera- 

 tion interfering with the contractility of the organ, but because 

 blood-clots may clog the urethra. After operations on the bladder 

 the urine discharged for the first day or two is liable to be mixed 

 with more or less blood. In simple operations the animal usually 

 recovers its normal spirits within two days. 



PREPUBIO LITHOTOMY. CYSTOTOMY. 



The abdominal cavity being opened and the bladder drawn for- 

 ward and surrounded with packs, an incision is made where vas- 

 cularity is seen to be least. In the presence of calculi the organ is 

 usually much hypertrophied and its vascularity increased; hence 

 persistent bleeding is prone to occur at the site of incision. All 

 bleeding points should be ligated or twisted though they tend 

 to stop of their own accord through the subsequent contraction of 



17 



