494 
DEPARTMENT OF SURGERY. 
membrane of the stomach, can also be successfully treated in 
this manner. 
GASTROTOMY. 
A, Vertical incision; b, transverse incision in line with blood vessels. 
Operation .—The patient must be cast, secured and anaesthe¬ 
tized ; the abdomen is opened as in celiotomy ; the incision 
made along the linea alba, and a secondary one may be made at 
right angle to the first. The incision in the stomach may be 
made in the pyloric or cardiac portion, and in some cases it may 
be made in the posterior wall, but in every case the incision 
should be made parallel to the large blood vessels. A small incis¬ 
ion should be made and the stomach explored with the finger, to 
ascertain the condition, then it should be enlarged just enough 
to enable the operator to accomplish his purpose. Sometimes 
the foreign objects are embedded in granulations which bleed 
extensively when the object is removed ; but, before closing the 
incision, such haemorrhage must be arrested. When purulent 
or bloody material is found in the stomach, it must be removed ; 
this can be done by a sponge held in a pair of forceps or sponge- 
holder. Cancers and ulcers can be curetted, and if confined to 
the mucous membrane only, the result of such treatment is 
generally beneficial (Annals of Surgery , Dec., 1887 s ). Cancers 
