DEPARTMENT OF SURGERY. 
921 
secondary suture. The abdominal cavity must then be irri¬ 
gated, sponges removed, and the cavity closed as in celiotomy. 
II. Uretero-rectostoiny .—Implantation of ureters into the 
rectum has been successfully performed experimentally, but its 
indications are not numerous, and its results are not very flat¬ 
tering ; the operation is often followed by renal disease and 
uremia {Journal of Ainerican Med. As., Feb. 16, 1901). The 
uremia being caused by the absorption of urine in the rectum. 
Renal disease results from the passage of bacteria to the kidney. 
When the bladder is not ruptured, and urethra is obstructed 
this interference is best replaced by making a recto-vasical fes- 
tula. The operation {uretero-rectostomy) is performed by open¬ 
ing the abdominal cavity ; the bladder if not ruptured must be 
emptied, and the ureters cut as near to the vesical extremity as 
possible, and this end implanted into the rectum by making 
an opening into it and suturing them so that the serous coat of 
the rectum will enclose the duct. 
This operation is the most simple of the three above 
mentioned, and the recoveries from it are greater, but the indi¬ 
cations are not numerous. Uremia and renal diseases are 
generally sequelae of the operations. 
III. Uretero-ureterostomy .—This operation is more uncer¬ 
tain than either ureterotomy or uretero-rectostomy, especially 
in very small patients. The operation has been successfully 
performed by some operators, but unfortunately, we have met 
with poor results from ureteral anastomosis, but would not dis¬ 
courage any surgeon if willing to resort to such surgical inter¬ 
ference when indicated. This is an intra-peritoneal operation. 
The ureter to be connected with its fellow must be disconnected 
from the connective tissue which attaches it to the sublumbar 
muscles, and peritoneum ; it is cut at the point selected ; the 
vesical portion is ligated and renal portion cut obliquely is 
partly invaginated into an incision made into the other ureter 
and carefully sutured so that the lumen of the dnct is not ob¬ 
structed. The procedure following the anastomisis is the same 
as in other secondary abdominal operations. 
HERNIA. 
The word “ hernia ” refers to the protrusion of the contents 
of a cavity through its parieties. In veterinary surgery it has 
lost its general meaning and is used almost exclusively as a 
synonym for “ abdominal hernia,” because the physical consti¬ 
tution of the abdominal cavity and contents of domestic mam- 
