TREATMENT OF UMBILICAL HERNIA. 535 



provided with a strong sterilised double silk thread. The threads, 

 when drawn through, are divided close to the needle, and the ends 

 of the one half tied tightly together, whilst an assistant draws the 

 sac gently upwards. The needle carrying the second half of the 

 thread is again passed through the sac about f of an inch from the 

 first point of incision, and this section ligatured in a similar way. 

 The same process is continued until the entire sac is ligatured. 

 Should the animal struggle whilst the needle is being passed, the 

 fingers of the left hand are placed on the umbilical ring to prevent 

 the intestine protruding and being transfixed, or one waits until 

 the animal is again quiet. The entire sac is then once more rinsed 

 with sublimate or carbolic solution, and the ligatures on both sides 

 of the sac powdered with a mixture of iodoform and tannin (1 to 3), 

 or the entire sac may be painted with wound gelatine and covered 

 with wadding. 



The animal is now allowed to rise and placed in a stall provided 

 with good clean straw. Should the above described precautions 



Fig. 391. — Kiihn's needle for ligation of the sac in umbilical hernia. 



be taken, the wound generally heals aseptically. In from ten to 

 fourteen days the ligatured portion of the sac sloughs away, and 

 the wound appears healed. The operation is performed in a similar 

 way at Brussels, but, instead of silk, strong waxed cords or hemp 

 threads are employed. To facilitate the work of ligation French 

 veterinarians use an iron clam, which is applied over the empty 

 hernial sac close to the abdominal walls. It prevents the portions 

 of bowel which enter the sac when the animal struggles being pene- 

 trated by the needle. This may just as easily be avoided by chloro- 

 forming the animal, or by carrying out the above described method. 



To prevent prolapse of the viscera during multiple ligation, 

 Mangot employs a long rectangular plate of lead, which has an opening 

 in the centre through which the empty sac is drawn and then ligatured. 

 Two wooden pegs are then thrust through the skin below the thread, 

 the sac is cut off, and the plate of lead fastened over the animal's 

 back by four straps, which pass through suitable holes at the corners 

 of the plate. Imminger has lately introduced this method in foals, 

 but he employs silver wire for ligation. If the wire is not too thin, 

 and not too strongly pulled, prolapse of bowel does not occur. 



