canula should be so placed as to readily
transmit the contents of the intestine, and yet form no impediment to
the stitches of the wound. When this has been done, a sponge moistened
in warm water and well washed should be employed to gently cleanse the
intestines from all foreign matters, and the gut, thus cleansed, is to
be returned to the abdominal cavity through the wound of the abdominal
wall. The patient is then to be laid upon a table and gently shaken,
in order that the intestines may resume their normal position in the
abdomen. If necessary the primary wound should be enlarged for this
purpose. When the intestines have been thus replaced, the wound in
the abdominal wall is to be kept open until the wound of the intestine
seems healed. Over the intestinal suture a little _pulvis ruber_
should be sprinkled every day, and when the wound of the intestine is
entirely healed (_consolidatur_), the wound of the abdominal wall is
to be sewed up and treated in the manner of ordinary flesh wounds.

If, however, the wound is large, a pledget (_pecia_) of lint, long
enough to extend from one end to the other and project a little, is
placed in the wound, and over this the exterior portion of the wound
is to be carefully sewed, and sprinkled daily with the _pulvis ruber_.
Every day the pledget which remains in the wound is to be drawn
towards the most dependent part, so that the dressing in the wound may
be daily renewed. When the intestinal wound is found to be healed, the
entire pledget is to be removed and the unhealed openings dressed as
in other simple wounds. The diet of the patient should be also of the
most digestible sort.

Thus far Gilbert has followed Roger almost literally. But he now adds,
apparently upon his own responsibility, the following paragraph:

_Quod si placuerit, extrahe canellum: factis punctis in sutura
ubi debent fieri antequan stringantur, inter duo puncta canellus
extrahatur, et post puncta stringantur. Hoc dico si vulnus intestini
sic (sit) ex transverso._

Apparently Gilbert feels some compunctions of conscience relative to
the ultimate disposition of the canula of alder-wood, and permits,
if he does not advise, its removal from the intestine before the
tightening of the last stitches.

Roland adds nothing to the text of Roger. But The Four Masters
(_Quatuor Magistri_, about A.D. 1270) suggest that the canula be made
of the trachea of some animal, and add:

_Canellus autem per processum te