462 
W. L. WILLIAMS. 
but I have not observed them. In one case I produced peri¬ 
tonitis of a severe type, owing- to too short a canula, from 
which the intestine repeatedly slipped and probably caused 
the lodgment of intestinal contents in the peritoneal cavity. 
In another case a very serious abscess took place in the ab¬ 
dominal walls, finally rupturing in the inguinal region. In 
this case the instrument was used in the dark, and the horse 
was thickly smeared with wet manure at the point of opera¬ 
tion, the case being one of unusual urgency. Several times 
small abscesses have followed the use of the trocar, but they 
• were insignificant and did not interfere with the daily work 
of the patient. 
It has been suggested that when the stomach is the seat 
of considerable gaseous distension, as evinced by attempts at 
vomition and eructations of gas, it should be attempted to in¬ 
troduce the trocar into it, and it has been claimed that this 
operation has been successfully performed by the use of an 
extra long trocar, introduced at the usual point for entering 
the colon or csecum, the practicability of the operation being 
explained upon the theory that when distended with gas the 
stomach turns on its longer axis and floats upwards. 
But in autopsies which I have conducted after rupture of 
the stomach, that organ was found in its normal position and 
the position of its former contents in the peritoneal cavity in¬ 
dicated clearly that the relation of the stomach had been con¬ 
stant. It is rare, however, that the stomach requires direct 
relief from gaseous distension, as the gases are most fre¬ 
quently formed in the intestines and pass forward into the 
stomach, or being formed in the stomach pass readily back¬ 
ward through the intestine until the colon is reached. 
The stomach does not rupture because the gas within it is 
under greater pressure than in any other parts of the alimen¬ 
tary canal, but because of the much greater surface upon 
which the gaseous pressure is exerted at the same rate per 
i unit of surface. If the colon be relieved by the use of the 
trocar, the stomach is immediately relieved also in nearly all 
cases. At least I have not observed rupture of this organ in 
any case where the colon was kept free from gaseous accumu- . 
