Etiology. 413 



placement through the foramen of Winslow. Among 1,408 horses dead from colic, 

 6.6% had suffered from internal strangulation. 



The statistics of 1889-1894 and 1896-1908 of the Dresden Clinic show among 

 3,336 eases of colic, thirty-two cases (0.9%) of internal strangulation; among these 

 four (0.12%) of diaphragmatic hern-ia; twenty-three (0.69%) of strangulation by 

 ligaments, clefts, etc.; five (0.15%) of displacement through the foramen of Wins- 

 low. Among 500 horses dead from colic, 6.4% died of internal strangulation. 



In the Budapest Clinic there were seen from 1900 to 1909 among 5,487 cases 

 of colic, fifty (0.9%) due to internal strangulation. Among 725 horses dead from 

 colic, 6.9% were due to internal strangulation. 



From the above data it appears that internal strangulation is comparatively 

 frequent among cavalry horses and that among these cases those due to hernia of 

 the diaphragm, to displacement into the foramen of Winslow and into clefts formed 

 previously to the strangulation, are more common than they are among other horses. 



Etiology. The intestines may become strangulated hj vari- 

 ous strands and bands present in the abdominal cavity. In 

 this respect are to be mentioned congenital diverticula of the 

 ileum (Meckels diverticula) ; exceptionally also acquired diver- 

 ticula of the intestines (Kitt) ; the ligament between kidney and 

 spleen (Marek, Forssell), the_ spleno-gastric ligament, the falci- 

 form ligament of the liver (Blanc), the urachus, the small omen- 

 tum (Dupuy) ; pediculated neoplasms (generally lipomata) aris- 

 ing from the abdominal wall or the mesentery, possibly also 

 from other abdominal organs, or exceptionally pediculated lobes 

 of the liver (Pecus) ; in horses also exceptionally a stump of the 

 spermatic cord, which has slipped back into the abdominal 

 cavity, or the spermatic cord of an undescended testicle (Gut- 

 brod) ; the larger omentum adherent to the anterior abdominal 

 wall and twisted into a cord, sometimes the anterior mesentery 

 itself (in a case of Dupuy and one of Prince, the cecum became 

 strangulated) ; finally postperitonitic connective tissue bands 

 with one free end or with ends connecting various abdominal or- 

 gans. Cysticercus tenuicollis caused strangulation of the duo- 

 denum in a hog (Spathe). 



In other cases internal strangulation is brought about by 

 portions of the intestines getting into congenital or acquired 

 openings of the mesentery or of the omentum, or into torn and 

 partially detached portions of the peritoneum or into a cleft be- 

 tween separated muscles (Roy). Some of the above mentioned 

 ligaments may also tear and in this manner produce intestinal 

 strangulation. 



In a similar manner there develops in oxen or young cas- 

 trated cattle, what is called internal hernia (Strangulatio 

 ducto-spermatica) a condition studied by a number of veteri- 

 narians, recently especially by Walch. This form of strangu- 

 lation occurs only after castration with twisting or rather tear- 

 ing off of the testicle, especially if the animals are castrated 

 during the first weeks of life. Walch has also shown experi- 

 mentally, that in such cases the reduplication of the peritoneum 

 (pouch of Douglas) attached to the spermatic cord between the 

 internal opening and the seminal vesicles, usually tears, so that 

 loops of intestines slip into the opening so made, either imme- 

 diately or later on. In other cases the stump of the spermatic 



