370 CLINICAL VETERINARY MEDICINE AND SURGERY. 



79. A five-year-old entire horse, brought to the school on the 5th 

 March, 1895. Since the previous night it had suffered from colic. 



Examination of the upper inguinal rings left no doubt as to the 

 origin of the abdominal pain, which was due to acute left-sided inguinal 

 hernia. 



The animal having been cast and suitably secured was anaesthetised 

 with ether, the scrotum was disinfected, and operation performed. On 

 enucleating the cord, the deep tissues (cremasteric fascia and tunica 

 vaginalis) w^ere found torn through externally for a distance of three to 

 three and a half inches. Having incised the vaginal sheath along the 

 lower margin of the testicle, strangulation was seen to have taken 

 place at the hernial ring, which was situated opposite the external 

 inguinal ring at a much lower point than usual. The hernial swelling 

 was composed of two parts. The first, above the hernial ring, was 

 rather larger than a man's fist, formed by a portion of intestine which 

 had thrust aside the vaginal tunic and drawn the peritoneum through 

 the internal inguinal ring, the anterior margin of which was torn. In 

 the other part, situated below the hernial ring, the intestine had already 

 undergone grave change, was blackish in colour, and in imminent danger 

 of becoming gangrenous. It was rinsed with boiled salt solution. 

 After enlarging the hernial ring by incision in an outward direction 

 reduction was easy, A little hesitation was felt as to the best method of 

 fixing the clamps, but it was finally decided, after torsion of the vaginal 

 sheath, to apply them to the cord and skin. This method was preferred, 

 firstly, as insuring against further protrusion of intestine, rendered 

 possible by tearing of the vaginal sheath, and favoured by patency of 

 the inguinal ring ; and secondly, as favouring adhesion of the skin to 

 the cord below the ring, and thus ensuring formation of a solid fibrous 

 cicatrix. 



The operative wound progressed favourably, but the herniated 

 portion of the intestine became gangrenous, and death occurred on the 

 sixth day. 



It is easy to explain the symptoms shown by this case. The hernia 

 presented two conditions of different age and character. The internal 

 inguinal ring had been abnormally large before strangulation ; the 

 peritoneum surrounding it had yielded under the continual tension, 

 and a loop of intestine had become extruded, forming a hernial swelling 

 in the depth of the groin. This swelling afterwards became compli- 

 cated with acute inguinal hernia. Tearing of the vaginal sheath 

 probably resulted from the repeated manipulation to which the scrotum 

 had been subjected before operation. 



80. A five-year-old setter bitch, left in hospital 15th March, 1893. 

 This animal had long suffered from inguinal hernia, which, however, 



had gradually increased in size during the preceding months. On entry 

 it was incommoded by the swelling, and sometimes appeared in pain. 



The swelling occupied the left inguinal region, and was the size of 

 a man's fist. Though tense when the animal was standing, it imme- 

 diately diminished and became flaccid when the animal was placed in 

 the dorsal position and taxis performed. It was perfectly reducible. 



