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been refused for the same length of time, only drink in small quantities being taken. Examination per anum revealed a strong distension of the pelvic flexure of the colon with gas, which had forced this part back to the hinder wall of the pelvis. On the outer face of the double colon there could be felt a very tense band which ran backwards, upwards, and outwards j a similar band ran in the same direction on the inner side of the double colon. The bladder was only slightly distended.
The hand introduced into the rectum was applied to the outer band in the manner above described, and after various attempts, and by the exercise of great force, I succeeded in moving the longitudinal bands of the colon towards the middle line of the abdomen. As soon as this had been effected, active peristalsis and passage of gas set in, and this was soon followed by the passage of firm excrement. The restlessness of the animal subsided, and after a short time disappeared j the pulse resumed its normal character, and the redness of the mucous membrane also disappeared. After an hour the colic could be pronounced cured.
TORSION OF THE LEFT PORTION OF THE COLON IN THE HORSE, AND ITS TREATMENT BY
By Dr MALKMUS, Guben.
THE experiences and recommendations which Herr J elkmann, as is known, brought forward regarding the above subject at the meeting of Naturalists in Bremen in 1890, have hitherto received no attention in veterinary literature. So many excellent methods of curing and so many good directions, which have in many cases proved impracticable or no better than the old, have been offered to the practitioner, that it is no wonder if he shows himself very reserved towards all innovations. I must confess that I myself placed little trust in Herr J elkmann's communications, so far as they related to the diagnosis of this disease, until a short time ago I learned of an improvement.
In the first place, du,ring the past summer I had accidentally in the clinique of Professor Moller an opportunity to convince myself that on the dead horse, placed in the normal position on its legs, it is possible to ascertain from the rectum the direction of, and to correct, a twist of the left portions of the colon artificially produced through a window cut in the abdominal wall. At the same time Professor Moller was good enough to inform me that he had by following J elk mann's recommendations diagnosed a twist of the left portion of the colon and treated it with the best results. I have now myself encountered such a case in practice, and arrived at the same favourable result. As the question of the possibility of making a diagnosis is of essential importance, I will here describe the case as far as is necessary.
During the night of the 9th August of this year a horse was brought to me with the report that on the previous morning it had first refused food and showed slight signs of uneasiness. During the day, while at work, the horse had been dull and had taken only a little food, but it had several times passed pultaceous fxces. Three hours previously it had been brQught home from work, and it then refused its food and lay down quietly. On examination I
t Translated from the Monatshefte fur praktische Thierheilkunde.
found the pulse strong and 48 per minute, redness of the conjunctiva, very slight peristaltic sounds on the left side, and none at all on the right. The horse made repeated attempts to lie down. I administered to the horse an electuary of 45 grammcs of aloes with ISO grammes of sulphate of soda, and allowed it to drink at will and have some exercise.
At 8 o'clock on the morning of the loth August the symptoms of colic had become more pronounced; the horse was more restless, lay down, and rolled. The abdomen was somewhat tympanitic; no passage of f<eces; no peristaltic sounds were audible. The mucous membranes were dirty red, the pulse had become smaller and 64 per minute. I decided to make an examination from the rectum. The anus was relaxed, and the bladder so full that the examination was rendered very difficult. After I had emptied the bladder by means of the catheter, I found the rectum so strongly contracted in its anterior part that it was not possible to penetrate further. After the introduction of half a pailful of warm water the rectum dilated, and I could conveniently feel the Jlortions of intestine within reach. I found a condition agreeing precisely with that described by J elkmann as occurring in twist of the left p;)rtions of the colon, viz., immediately in front of the entrance to the pelvis a band running from the vertebral column downwards and to the left; slight pressure on this caused great pain. Farther forwards I found in the lower part of the flank, near the mesial plane, and running backwards and to the right, a band which was also painful when touched; under this I felt a widely distended intestine (pelvic flexure). I had no longer any doubt that I had before mea case of twist of the colon towards the right. With the left shut fist I tned to push the latter portion of intestine along the abdominal wall towards the right, and in this I was successful; I could no longer feel the muscular bands, and thought that I had undone the twist. However, the symptoms of colic did not abate, and after an hour I again examined and found the same condition as at the first examination. The displacement had therefore not been removed, or at least not completely, by my manipulations. I repeated my efforts exactly according to J elkmann's recommendation, and at last had the pleasure of feeling as if the upper portion of the colon were falling suddenly over on my fore-arm. From this moment the horse was quiet, and did not again lie down. It several times drank some water; within an hour a large quantity of gas was passed, and the tympanites diminished. After the lapse of three hours the horse passed dung for the first time, and this was followed by several defxcations shortly after one another. During the evening the horse's appetite had returned, and he took some hay and linseed gruel. On the following day the animal was in a state of health.
Undoubtedly, there had been in this case a twist of the colon to\vards the right, which had been removed by retroversion.
From the whole series of symptoms it must be concluded that on the night of the 9th August this displacement of the intestine was not yet present, but rather that it was first brought about in the further course of the colic. The failure of my first effort ,vas due to the fact that I had not raised the piece of bowel in the proper manner. \Nhile one still pushes towards the right, one must gradually raise the bowel with the knuckles, in order to allow it at the same time to roll over the back of the hand. I consider it best to operate with the shut fist, since in the living subject the rectum is easily perforated. The retroversion is not effected immediately, and during the efforts one must not lose either coolness or patience. In my case it did not suffice to push the bowel as far as the middle line; I had to go farther. Judging by all experience, without the manual retroversion of the intestine the horse would certainly have died. J elkmann has shown us an
important step forwards in the therapeutics of colic, by teaching us how to diagnose and to overcome displacement of the left portions of the colon.
There is one point, however, in which I must decidely differ from J elkmann, and indeed also from the view general among veterinary surgeons, viz., that the rolling of horses suffering from colic is not dangerous. In this connection it is usually pointed out that horses in the fields very frequently roll, and that this never causes a displacement of the intestine, for if such were the case horses would soon cease to exist. But it is not justifiable to reason immediately from the conditions in a healthy horse to those existing in one diseased. In a healthy horse the intestines are only moderately filled, and are in a condition of uninterrupted vermicular movement; although the intestines of the horse are for the most part suspended by long mesenteries it is very seldom that a permanent displacement of intestine occurs in a bowel working normally, for each piece of bowel in virtue of its movements returns to the position assigned to it by nature. The case is different in colic. A defective onward movement of the intestinal contents generally lies at the root of colic, and very frequently leads to an impaction. If this goes so far as to cause a portion of the intestine to be overfilled and inactive, then rolling on the part of the horse can easily lead to displacement of a quiet-lying part of the bowel. I need only recall here a similar process known to every veterinary surgeon, viz., torsio uteri of the cow. Concerning the production of this various views still prevail, but in therapeutics we are all agreed: we roll the animals. 'vVe roll the animals-as the correct expression must indicate-towards the twisted uterus. \Ve know from observation that when an animal is suddenly and quickly rolled the heavy uterus may remain in its position, so that the animal turns round its uterus; the torsio uteri is then removed. According to the view generally prevalent one ought to allow horses suffering from colic to roll, because any twisted portions of bowel might thus be freed; and will anyone yet assert that no intestinal .displacement can be brought about by rolling? The intestine as well as the uterus is fastened by long soft bands to the trunk, and movements proceeding from the latter are not immediately transmitted to the viscera lying loose in it, since no friction takes place between the abdominal wall and viscera. The more suddenly a violent movement of the trunk takes places, the easier can a displacement of the intestines in the opposite direction take place. Friedberger and Frohner point to the fact that in slaughter-houses where pigs' and calves during unloading etc. are much rolled about, recent twists of the intestine are found after slaughter. From this it may be inferred that even in healthy animals twist of the intestine may be brought about by rolling. But in animals whose intestine subsequently works in the normal manner, these displacements again disappear through the.peristaltic movement; but where the intestines are over-filled and motionless the correcting factor is absent, and reposition does not always take place. The small intestine and the floating colon cannot be easily displaced during rolling, because they are fastened to the highest point of the abdomen by means of a long mesentery, and by their weight always press in the contrary direction. The colon, on the other hand, is fastened only by its anterior portion,
330 GENERAL ARTICLES.
whereas its posterior parts project freely. The latter are certainly during rolling exposed to most danger, because the movements of the trunk in rolling are slowly communicated to it. In rolling towards the left, the right abdominal wall presses against the right portions of the colon and thus keeps them in position; but the left wall of the abdomen separates itself from the left portions, which therefore cannot immediately execute the same movement, and still retain their position for a moment, while the trunk has already described a quarter or half a turn round its long axis. In that way a twist of the colon towards the right is brought about. In rolling towards the right, on the other hand, the right portion of the colon is in more danger than the left. Twist of the colon must thus, as a rule, incline towards the middle line of the body. This explanation is in complete harmony with the fact that of all displacements of the intestine twists of the colon are by far the most frequent; and, further, that the left portion of the colon is dislocated towards the right, but the right towards the left.
I would therefore recommend that horses suffering from colic should be prevented from rolling and springing up quickly, as long as one may assume that a displacement of intestine has not yet taken place. But when one is convinced that a change of position is present, rolling may be permitted. There is then a possibility that the horse may himself unroll the twist and thereby remove it. \\Then other parts are twisted rolling can never be injurious, but only useful. But if it can be ascertained that a twist of the colon in a definite direction exists, one should undertake retroversion: if that does not succeed the horse is to be rolled in the direction of the twisted portion of intestine.
ANTISEPTIC VETERINARY SU RGERY.
By J. R. U. DEWAR, F.R.C.V.S., Aberdeen.
IT is a well known fact that the professions are largely conservative, not only in their politics but also in their professional ideas and practice; and the older we grow we become the more conservative and the more tenacious of our own opinions. But the writer of an editorial article in the September number of Tlte Journal of Comparative P atltology and Tilerapeutz'cs on "Asepsis in Veterinary Surgery" seems to be like the Athenians of old, "too eager to hear 'and to tell of some new thing," and to accept it as an improvement on the old.
The article referred to is evidently inspired by an abstract from the Reclteil de flf cdecine Vitcrillaire, July 189 I, which appears in the same number of the Journal. In this abstract a French veterinarian describes the castration and treatment of two horses, in which he tried to carry out the antiseptic system after the most approved methods. of Listerism. But any practical veterinary surgeon, after perusing the account given of these two cases, with all the elaborate paraphernalia of spray, protective medicated dressings, and bandages, will, surely, agree with me in thinking that its general adoption is out of the question; and that it will never be used but in special cases where extra risk exists, or in the case of quiet and very valuable horses.