374 
PUNCTURE OP THE BLADDER. 
m dogs. Hering states having completely cured a dog by his method, 
though he does not say what caused the difficulty in urination. 
(2) In large animals puncture is effected from the rectum (punctio 
rectalis). 
-This is the easiest method and that usually followed when it is 
desired, as often happens in oxen, promptly to remove the danger of 
luptuied bladder, and it is intended to slaughter the animal in a short 
time. The canula, guided by the left hand and with the trochar 
drawn back (covered), is introduced into the rectum, and directed as 
nearly as possible perpendicularly to the surface of the bladder. It is 
veil not to go much beyond the neck of the bladder, but rather to pierce 
it close behind the neck, so as to avoid opening the peritoneal sac. 
(3) Punctio perinealis deserves preference in large animals unless 
when destined for early slaughter. Inflammation of the urinarv bladder 
is less likely than in punctio rectalis, where it readily occurs in con¬ 
sequence of infection from the rectum. The skin is incised close below 
the anus and somewhat to the side of the urethra, and efforts are made to 
penetiate thence as far as the neck of the bladder by working with the 
fingeis, assisted when needful with knife and scissors. As soon as the 
distended urinary bladder is felt, a straight trochar with the point 
covered is introduced, placed on the bladder and the stilette pressed 
forwards. On withdrawal, urine is discharged through the canula, 
which is slowly thrust forward so as to follow the movement of the 
collapsing walls of the bladder. Should a single evacuation suffice, the 
trochar is at once removed; it is not necessary to suture the skin 
wound. Hering recommends, after making the cutaneous incision, to 
thrust the trochar directly forwards in the direction of the urethra, as 
fai as the bladder, without dividing the connective tissue. When con¬ 
siderably distended, the bladder can scarcely be missed. Should the 
prostate or vesiculae seminales be injured little harm results, especially 
in castrated animals. On the other hand, however, there is no reason 
against providing, as far as possible, a safe passage for the trochar, 
especially if antiseptic precautions be taken. If it is desired that the 
animal shall live for a considerable time after operation, this method 
certainly deserves preference, as, in the event of a repetition of the 
opeiation becoming necessary, it will be much easier. 
The canula may remain in position for one to two days; in oxen 
intended for slaughter this is to be recommended, and an additional 
advantage is that the trochar may here be more easily fixed in position 
than in the rectal operation. 
In quiet animals the above operations may be performed standing, by 
extending the hind feet and applying a twitch. Piychner recommends 
the dorsal position, because it allows the bladder to be still more easily 
