534 TREATMENT OF UMBILICAL HERNIA. 



behind the rupture. One injection is said to be sufficient to cure 

 small hernise in four to six weeks. Thickening remains for some 

 time, but this is thought to close the ring. Lucet injects from 

 2 to 7 ounces of a similar solution all round the ring. 



These methods assist return of hernial contents to the abdominal 

 cavity by the swelling they cause, an action which is continued by 

 the subsequent cicatricial contraction of the skin. Acids are pre- 

 ferable to blistering ointments, as, e.g., cantharides ; and Hupe 

 states that inguinal hernise in foals can be cured with certainty during 

 the first six months of life by smearing with sulphuric acid. 



This treatment is only suitable to small hernise in young animals ; 

 in larger herniae it is of no value, and Degive restricts its use to cases 

 where not more than two fingers can be introduced into the hernial 

 opening, and where the sac is not larger than a hen's egg. Where 

 irritants have failed, the hernial contents often become adherent 

 to the sac, and may later cause difficulty in operative treatment. 



(3) The following methods of radical treatment have been 

 employed : — ■ 



(a) Simple or multiple ligation of the sac. This is best performed 

 in spring or autumn and at a time when the animal is otherwise in 

 good health. The limits of the sac should be marked before casting. 

 In hernia not possessing too broad a base the parts are first carefully 

 replaced (the animal having been placed on its back and the hind- 

 legs bent), and a ligature passed around the neck of the sac. Esser 

 recommends for this purpose the elastic ligature. When, ten to 

 twelve days later, this falls off, together with the hernial sac, a cicatrix 

 has formed in the position of the latter, which prevents prolapse of 

 the bowel. The elastic ligature should, however, not be drawn tight 

 enough to cut rapidly. To prevent its sliding off, a strong needle 

 may be passed through the sac below it. 



Degive takes up as much as possible in the ligature, and draws 

 this quite tight. According to him the method is very successful 

 in ruptures where the abdominal opening is not of greater diameter 

 than the thumb. Where the base is broad the cord easily slips off ; 

 removal by multiple ligature, i.e., ligation in sections, is then pre- 

 ferable, and in foals, and even in older horses, gives good results- 

 Procedure is as follows : — The animal is cast, placed on its back, 

 the hind legs bent and drawn outwards, the hair shaved from over 

 the hernial sac, and the latter washed and rinsed with a disinfecting 

 fluid. After complete reduction, the folds of the sac are gathered 

 together in the direction of its long axis, and, beginning at one end, 

 transfixed close to the abdominal wall with a slightly bent needle, 



