LIGATION. 
347 
disappeared and did not recur. In reposition care must be taken to 
simultaneously reduce the invagination. For this purpose it is not 
sufficient to thrust the protruded bowel through the anus, but the 
extreme end must be carried forward at least twice the length of the 
prolapsed part. In large animals this is best effected with the arm, in 
the smaller (dogs) by means of a tallow candle. Btockfleth used a 
stick; the end covered with tow and rubbed with fat. Infusions of warm 
water injected whilst the hind-quarters are raised may also assist reduc¬ 
tion. The animal should be laid with the hind-quarters high; if small 
it may be lifted by the hind legs. When the animals strain violently, 
narcosis must be resorted to, for which purpose morphine is very useful. 
The greatest obstacle to reposition and permanent cure lies in this severe 
straining. Large animals should, therefore, be watched for some hours, 
and if it sets in, pressure should be exerted over the loins. Mild clysters 
and the application of cold combat inflammatory symptoms about the 
anus and rectum. 
To ensure retention, the anus may be sutured. Strebel inserts two 
strips of leather in the neighbourhood of the ischial protuberances, and 
crosses them over the anus; by applying tow or sponges below these 
the intestine is held back; in horses, the tail has been fastened so far 
forward with a pair of straps as to exercise pressure on the anus. 
Andre’s “ tobacco-pouch ” suture has been recommended. This is a 
continuous suture, made by passing a narrow tape in and out under the 
skin, and working in a circle ; it should be left in position for twenty- 
four to thirty-six hours. To allow of defecation the tape is, when 
necessary, loosened, and afterwards again drawn tight and knotted. It 
is clearly not to be employed in cases of invagination where its use 
would be irrational. Cocain ointment injected into the rectum may be 
tried in severe training. 
When prolapse with invagination has already existed for several days, 
reposition becomes impossible, nor should it be attempted if structural 
change has occurred. Nothing, then, remains but to remove the pro¬ 
truded portion, for which purpose one of the following methods may be 
employed, viz. :— 
(1.) The use of irritants. lessen powders the protruded parts four 
or five times a day with sulphate of copper and pulverised charcoal in 
equal parts ; inflammation results, and in a few days a scab forms 
(necrosis), after which the prolapsed part sloughs off in eight to fourteen 
days. Danish practitioners have used this material with success in 
large animals and swine, but others consider it useless; Weber, after 
trying it in foals, was finally forced to operate. It can, of course, only 
be used in prolapsus ani et recti without invagination. Apart from the 
uncertain action of this treatment, it must be remembered that it is 
