ON THE DISOEDEES OF THE DIGESTIVE APPAEATUS. 147 



The Exceetoet Appaeatus of the Liver. — The dog is 

 the animal most frequently used by physiologists for ob- 

 taining bile in a perfectly fresh state. The non-liability 

 of the dog to traumatic peritonitis, and the facility of 

 access to his bile-duct accounts for his usually being 

 selected for the production of a biliary fistula. Gamgee 

 thus describes the operation: "An incision three or four 

 inches long is made in the linea alba, commencing at the 

 xiphoid cartilage, and the peritoneum having been care- 

 fully divided the liver is raised, when the gall-bladder 

 comes into view. This having been seized with a pair of for- 

 ceps and drawn to the surface, the cystic and hepatic ducts 

 are seen joining to form the common bile-duct, which is 

 easily seen entering the duodenum. Two ligatures are then 

 passed around this duct, one being placed as near the gut 

 as possible, the other near the origin, of the duct. The 

 portion between the two ligatures is cut out. The gall- 

 bladder is no\7 fixed to the anterior part of the wound by 

 means of metallic sutures, and then opened sufficiently to 

 admit the little finger. The rest of the wound is closed 

 by metallic sutures ; tbe quill suture is, perhaps, the best. 

 Care must be taken to bring the wound in the muscles 

 together before sewing up that of the skin. After the 

 operation a wide roller is passed round the belly of the 

 dog, a bole being made in it to allow the escape of the 

 bile. If matters proceed satisfactorily the wound in the 

 abdominal wall heals, except where the opening in the 

 gall-bladder becomes adherent." 



Biliary Calculi are not rare in the dog ; they vary in 

 consistence from inspissated bile masses to hard concre- 

 tions. They prove of importance either as causing jaun- 

 dice by entering the duct and obstructing it or else by 

 the acute pain which occurs during their passage. When 

 jaundiced animals suddenly manifest acute pain by ex- 

 treme violence and loud cries it is generally due to pas- 

 sage of gall-stones. This must be # encouraged and 

 rendered less painful by warm baths and administration 

 of opiates, and immediate relief, not only of the pain but 

 also of any jaundice associated with it, will follow expulsion 



