326 
RUMENOTOMY. 
strong, drawing movement, the wound is now carried downwards, in 
oxen for a distance of 4 to 6 inches, in sheep 1J to 4 inches. To prevent 
food entering the peritoneal sac, it is necessary to avoid making the 
skin wound smaller than that in the wall of the rumen. 
The operation may also be carried out by first cutting through the 
skin at the point indicated, dividing the abdominal muscles, and finally 
incising the peritoneum and wall of the rumen. 
Immediately the rumen is opened gas and fermenting masses of food 
often rush out with considerable force. To prevent the rumen col¬ 
lapsing after evacuation and allowing food to enter the peritoneal cavity, 
a handkerchief, or serviette, is so placed that one portion extends from 
the lower angle of the wound into the rumen, and the other lies on the 
outer surface of the abdominal wall. With the same object, Horsburgh 
and Roche-Lubin stitched the rumen to the abdominal wall. The latter 
operates like Hertwig, by thrusting a bistoury through the walls of the 
abdomen and rumen, a little above where the trochar is inserted. After 
allowing gas and some food to escape, the incision is carried downwards 
about 4 inches; tapes are passed through both rumen and abdominal 
wall on either side, and about 1 inch from the edge of the wound, 
by means of a bent needle. The tapes are introduced from within 
outwards, and each carries at its end a mass of tow, which acts like a 
knot; the free ends, being drawn apart, open the wound and prevent the 
rumen collapsing. 
Whichever method is adopted, the rumen should be emptied as far as 
possible, either with the hand or a pair of forceps ; but this must be 
done gradually to prevent the animal becoming unconscious and falling- 
down. Certain operators state that stimulants, like wine or brandy, 
produce a good effect in such cases, and recommend pouring through the 
opening in the rumen four to six pints of wine, or a suitable dose of 
aether, alcohol, &c. 
After the rumen has been emptied, the wound cleansed, and care 
taken that no food has entered the peritoneal cavity, or that what has 
entered has again been removed, the wound in the rumen is closed with 
catgut or silk, interrupted sutures being used. These are placed so close 
that no food can pass, and it is very important that the edges of the 
wound lie in close apposition. The opening in the abdominal muscles 
is sutured in a similar way, though that in the skin may be left patent 
without disadvantage. If, however, healing by first intention is desired, 
the skin should also be sutured. Sometimes the wound heals in a few 
days, but may take weeks and even months, or leave behind a fistula 
of the rumen. 
Obich recommends suturing the wall of the rumen to that of the 
abdomen, and leaving the stitches in for seven or eight days. Meyer 
