DEPARTMENT OF SURGERY. 
431 
made. If the intestine is diseased or badly injured, the portion 
thus affected should be resected before anastomozing, and in every 
instance the anastomosis must be anterior to the part resected 
or to the portion that is to be relieved of its function. After all 
the initiatory work has been completed an incision is made at 
the point of each division to be connected and the two portions 
sutured together by two rows of stitches surrounding the in¬ 
cisions. The sero-muscular series of stitches may be applied 
first to about tliree-fourtlis or two-thirds of the circumference of 
the surgical wound and the stitches ligated on the inside; this 
part being completed, the muco-mucous series should be applied 
and as many of them ligated inside as possible, and the remain¬ 
der on the outside, after which the sero-muscular series may be 
finished. The sero-muscular suture must be made of catgut and 
the muco-mucous of silk. 
When all the intestinal work has been completed, the cavi¬ 
ty must be irrigated with sterilized water and the intestine re¬ 
turned into its proper place, avoiding the formation of a vol¬ 
vulus or an invagination ; and the cavity closed and treated as 
in celiotomy. 
If upon opening the cavity it is ascertained that the alarm¬ 
ing condition is due to an intestinal occlusion, caused by a 
stricture or enteroncus, the diseased portion should be treated 
as the indication demands ; strictures resected and tumors ab¬ 
lated, together with such other interference as may be consid¬ 
ered conservant. 
