PUNCTURE OF THE BOWEL. 
315 
abdominal wounds in the horse and the failure of surgical laparotomies 
for bowel obstruction are probably explicable on this ground alone. 
Should the portion of bowel surrounding the foreign body be necrotic 
or in process of becoming so, it may as a last resort be lesected, caie 
being taken to operate in sound tissue. A triangular piece of mesentery 
having the bowel for its base is at the same time lemoved. Lhe ends 
of the bowel are then turned inwards and the opposed serous surfaces 
united by means of numerous tine silk sutures. McQueen used cambric 
needles and fine sterilised silk. The best form of suture is probably 
Lembert’s. A second series of sutures is then inserted so as to bring as 
large a surface of the serous coat as possible into contact. As shown by 
Dollar’s experiments, adhesion of the serous surfaces is remarkably rapid. 
To shorten and simplify the process of uniting the serous coats Murphy 
introduced a “ button” in two parts, one of which was inserted m each 
end of the bowel and secured by passing a tobacco purse stitch around 
the periphery of the bowel. When pressed together the two extremities 
of the button automatically engaged and kept the two serous surfaces of 
the bowel firmly in contact. In four to five days the button became 
loosened in consequence of those portions of bowel included within it 
undergoing necrosis, leaving a circular line of union around the owe . 
The button was passed per rectum. 
Murphy’s button has often been successfully used m dogs; Murp y 
himself made more than 600 experiments, but McQueen’s experiments on 
horses failed, and in these animals the method cannot be recommended. 
Decalcified bone tubes might be useful in the larger animals. 
II.— PUNCTURE OF THE BOWEL IN HORSES 
(PUNCTIO INTESTINI). 
In horses, colic is often accompanied by active production of gas m 
the colon and cscum, by which the diaphragm is pressed forward and 
respiration impaired, in consequence of the lungs being pressed on 
and the posterior ribs fixed. Suffocation may even be threatened, 
and circulation in the abdominal viscera so affected as to endanger 
life. The animal’s recovery, therefore, depends on speedy removal o 
the <ias The more marked the respiratory disturbance, the shallower 
and more frequent the breathing, the greater is the danger. In extreme 
cases the animals become unsteady on their legs, staggei about a 
down, and die in a few minutes. Crib biting induces the same symptoms, 
though in a minor degree, and seldoms leads to death, but tympanitic 
colic produced by fermentation in the intestinal canal, often takes a 
fatal’ course, the reason being that in the one case air ceases to be 
swallowed as soon as the animals experience discomfort or pain, whilst 
