BOWEL FISTULA. 
259 
wounds, prolapse was noticed fifteen times. Of fourteen horses, two mules, 
two cows, and one dog, two horses, one cow, and one mule died. This result 
gives, however, no indication of the relative gravity of these abclominal 
wounds, the successful cases apparently having been selected for publication. 
The course is usually less favourable. Jewsejenko saw thirty-one abdominal 
wounds in the horse during the Russo-Turkish war. Those caused by large 
projectiles were the gravest. The smaller the projectile, the less the danger. 
Of eight horses with shot-wounds injuring the bowel, five died with peritonitis , 
three recovered after suturing the wound. Two wounds of the stomach, 
produced by splinters of granite, led to death. One wound of the stomach 
from a ball was sutured and healed. Of four wounds of the liver, three were 
fatal; one case recovered. Of three wounds of the spleen, two. ended fatally , 
one recovered after the projectile had been removed with dressing forceps. 
After penetrating wounds of the abdomen, animals, like men, some¬ 
times die rapidly from collapse. It was formerly believed that this 
peracute progress was owing to shock; but more recently it has become 
evident that the active agent is profuse bleeding into the abdominal 
cavity. This must be borne in mind, and in recent injuries the pulse 
and mucous membranes must be examined before giving a prognosis, or 
attempting operative interference, which may be blamed for the animal s 
unlooked-for death. 
In order to study the effect of injuries produced by pistol bullets discharged 
into the abdomen, Parkes experimented on thirty-seven dogs ; three died 
immediately from bleeding from the aorta, or from the renal, or splenic 
arteries ; twelve lived for one day, and then died from bleeding, with appear - 
ances of shock. The others lived longer ; but in almost all the bowel contents 
obtained entrance into the peritoneal cavity, though they could not be detected 
in the skin wound. Of the twenty-one which did not immediately perish, two 
died from peritonitis. Of twenty-one treated by laparotomy, ten died in fiom 
three days to three weeks, and nine were cured. 
Chaput also produced experimental abdominal wounds and injuries of the 
abdominal organs in dogs. Of those subjected to immediate tieatment the 
whole recovered ; where treatment was expectant only 32 per cent.. Chaput 
therefore recommended performing abdominal section in the middle line, 
drawing forward and fixing the bow T el by passing a directoi through the 
mesentery, and seeking out and suturing the injured spot. Ranzillotti- 
Buonsanti collected a large number of clinical records referring to. various 
forms of abdominal injury, from simple perforating wounds to such as involved 
severe injuries of the contained viscera. Of eighty-three cases in solipeds, 
sixty-five recovered and eighteen died ) five cases in cows all recovered, as 
did four cases in pigs. Numerous recoveries from similar injuries have more 
recently been recorded, thanks to antiseptic treatment. 
III.—BOWEL FISTULA (ANUS PRETERNATURALIS). 
The term bowel fistula is applied to a direct communication between 
the lumen of the bowel and the external air through the intestinal wall. 
A probe introduced into the fistula passes through the abdominal walls 
directly into the bowel. The opening may occur at different points, but 
s 2 
