526 METHODS OF CURE IN HERNIA. 



the hernia. These measures may be supplemented by the 

 following : — 



(1) Hernial truss. Although much used in men, trusses cannot 

 be employed to the same extent in domestic animals. Trusses for 

 inguinal hernia? in animals, other than foals, are impracticable, and 

 it is only in exceptional cases that they can be continuously worn 

 in other abdominal hernise, though the male hippopotamus in tjie 

 Berlin Zoological Garden wore such a truss for a considerable time. 

 These appliances will be described in speaking of inguinal hernia?. 



(2) Diminution in the hernial sac and return of the hernial contents 

 into the abdomen, by inflammatory and cicatricial processes in the 

 skin of the sac produced by sulphuric, nitric, or chromic acid, by 

 the application of the actual cautery, or by subcutaneous injections 

 of common salt, alchohol, &c. The artificial inflammation is accom- 

 panied by swelling in the skin and subcutis, and the contents of the 

 hernia are said to be gradually forced into the peritoneal cavity. 

 Cicatricial contraction of the cutis follows, and thus diminishes the 

 size of the hernial sac, and even of the hernial aperture. The cautery, 

 lately recommended in man, has the same effect. Radical treatment 

 consists in removal of the sac and closure of the hernial aperture 

 by causing the hernial ring or the neck of the hernial sac to unite, 

 or by other methods. This procedure presents" greater difficulties 

 in animals than in men, because it is neither so easy to attain asepsis, 

 nor to keep the animal in the necessary dorsal position after 

 operation. 



The following methods of radical cure are employed : — ■ 



(1) Ligation of the hernial sac. This can only be resorted to where 

 the sac possesses a narrow neck. To prevent displacement of the 

 ligature, it has been recommended to pass needles transversely through 

 the neck of the sac, and to apply the ligature over them. It need 

 scarcely be said that the hernia must first be reduced. 



(2) In hernia with a broad base interrupted ligatures may be 

 employed. After returning the hernia, strong threads of sterilised 

 silk are passed through the neck of the sac close to the hernial opening. 

 The procedure consists thereafter in multiple ligation ; the skin of 

 the hernial sac can then be cut through and separated from under- 

 lying tissues, the other coats of the hernia similarly treated, and 

 the skin brought together over them. This method is frequently 

 employed, and usually allows of healing by first intention, which 

 greatly tends to ensure success. 



The hernial sac may also be opened, and, after multiple ligation 

 of its neck, removed, following which the skin should be closed with 



