_The Trocar Method._—In this method a trocar varying in length from six to fourteen inches is used. It may either pierce the abdominal wall through the umbilicus, or two inches above and two inches to the left of the umbilicus. Then after the trocar has entered the abdomen the secret of removing gases successfully depends very largely upon the operator having a very correct idea of the location of all the abdominal organs. It is difficult to know when the trocar has pierced the interior of the stomach, or in fact even to make it pierce the stomach at all for the peritoneum which is a covering for all the organs of the abdominal cavity contains a serous fluid which makes the organs slippery, and even the sharp pointed trocar often does not take hold as it should. Again it must be remembered that the stomach is a hollow organ, and for example let us try to pierce a soft rubber ball, containing air and a small opening, a condition resembling the stomach, with a trocar, we know that the one wall, will have to be pushed up against the other wall, and then placed against something firm, before the trocar will pass through. Just this condition happens with the stomach when the trocar tries to pierce the arterial wall of the stomach there is nothing solid to bear against and consequently the front wall will be pushed up against the back wall and then if enough pressure is now used to push the trocar through, it is very liable to pass all the way through both walls. Again it must be remembered that the descending aorta passes very close behind the stomach and should the trocar go all the way through the aorta might be pierced and the circulation in a measure ruined. The one main disadvantage of this trocar method is that the operator is always working blindly, it is always impossible to tell just how much damage may be done to the internal organs and the circulation, and again should the operator desire to place fluid in a certain part—say the inside of the intestines or the inside of the stomach or the colons, will the operator have assured knowledge that he has actually placed the fluid in the part desired. From the number of experiments that have been carried out in our anatomical rooms, the proof seems to be in every case that the fluid has not reached the part it was supposed to reach. The advantage of this method is the fact that by introducing the trocar into the abdominal cavity two inches above and two inches to the left of the navel that after the abdomen has been treated that the trocar then can be directed upward into the thoracic cavity and fluid there distributed to the several parts, but this is seldom necessary. After the trocar has been removed or better, just before the trocar is entirely pulled out the operator should sew a circular stitch about the wound and then as soon as the trocar is pulled out, pull the stitch closely together as if it were a draw string, and tie. This will prevent any further leakage from the part.