TREATMENT OF NON-STRANGULATED HERNIA. 525 



But both in men and in animals the first causes may be so varied 

 that they cannot usually be explained, and therefore the question 

 is here of no great importance. 



The views on omental strangulation are just as varied, though 

 all coincide in declaring that omental hernise are less often strangu- 

 lated than intestinal. Some, like Rose, altogether doubt its 

 occurrence, and have, supported their opinions by experimentally 

 ligaturing the omentum. Others allow its occurrence, and insist 

 that its symptoms are similar to those of strangulation of the in- 

 testine, but less pronounced, because the circulation alone is inter- 

 fered with. 



Diagnosis is seldom difficult. As a rule, symptoms of colic appear, 

 and in carnivora vomiting. The pain is regular and lasting. In 

 cases of colic in ruptured horses care should invariably be taken to 

 first examine the hernial sac. If strangulated, the hernia will be 

 found to have increased in size, become hard, painful, and tenser 

 than formerly. Symptoms of peritonitis set in, and the animal 

 soon dies if reduction is not effected. The occurrence of albuminuria 

 in strangulated hernia is certainly interesting from a scientific stand- 

 point, but not clinically. 



Prognosis. Strangulated hernise usually kill in a short time, 

 not infrequently in twenty-four hours, and as reposition is often 

 difficult or comes too late — that is, when necrosis has already set 

 in— the condition must always be viewed as dangerous. Spon- 

 taneous reduction is exceedingly rare, partly on account of the 

 increasing accumulation of ingesta in the hernial loop, and partly 

 because the incarcerated section of bowel soon becomes paralysed 

 in consequence of defective circulation, and is then unable to discharge 

 its contents, even when the causes of strangulation have been removed. 



Treatment of non-strangulated hernise. In many cases, par- 

 ticularly in slight hernise in young animals, no treatment is re- 

 quired, because spontaneous recovery is usual, strangulation rare. 

 Peculiarities of treatment will be separately described in connection 

 with each of the various hernise. One differentiates a palliative 

 cure, and a radical cure. The first consists in bringing about a gradual 

 diminution in the hernial sac ; the radical cure in closing the hernial 

 opening. 



The palliative cure depends on suitable dietetic precautions, 

 supplying concentrated and easily digested food, avoiding hard 

 work, and in larger animals on the preservation of a suitable position, 

 that is to say, a position in which, whilst the animal is in the stall, 

 the viscera will be as far as possible removed from the position of 



